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During January, February and March, 1921, 54 cases of diphtheria occurred
among the 90,000 untreated school children, whereas among the 90,000, who had been
tested and when positive (non-immune) had been given two or three injections of
toxin-antitoxin, there were only 12 cases, i.e., there were four and a half times as
many cases of probable diphtheria among the untreated 90,000 as among the tested
90,000. Four cases of diphtheria occurred among 8,200 children originally Schick
positive who had not been re-tested since the immunising injections.
Every effort was therefore being made in New York to secure the immunisation
of all school children. It may be pointed out as corroborative of the results of the
preventive measures by active immunisation adopted in America that during 1921
in New York City diphtheria cases and deaths were less numerous than ever before,
the death rate from diphtheria for 1921 falling to .16 per 1,000 population. This
improvement, moreover, was maintained in 1922, when the diphtheria death rate
fell to .15. Support of the prophylactic value claimed for anti-diphtheria
immunisation is forthcoming, not only from workers in other parts of America, but
also from limited observations made in this country.
Dr. R. A. O'Brien and his colleagues of the Wellcome Research laboratories in
1921 undertook the testing and immunisation of the inmates of two poor law schools
in Mitcham and Norwood, owing to the prevalence of diphtheria in the two institutions.
At Mitcham in August, 1921, all the children aged 3 to 14 years, numbering
329, were Schick tested, and 102 who were found to give positive reactions received
injections of toxin-antitoxin. As a sequel to this successful immunisation, no
further cases of diphtheria have occurred in the school in the past 18 months up
to date.
Similarly at the Norwood school, where there had been much diphtheria since
1916, 600 children were Schick tested and the positives were given toxin-antitoxin,
with the result that no further cases of diphtheria have occurred among those immunised.
But as it was not possible to complete the testing and immunising of all
the children, it is important to note that some 20 cases have developed since among
the unprotected; a fact which may be regarded as evidence in support of the value
of artificial immunisation. During the last 4 years London has been through combined
waves of scarlet fever and diphtheria prevalence, the crest of which was
reached in the autumn of 1921. Under these special circumstances the scheme
now in force in America, for the prevention of diphtheria in New York and elsewhere,
has been carefully watched. The experience there forthcoming during the
next year or two will be followed and studied with the closest attention. It is to be
hoped that the future may show a distinct decline, such as appears to have already
occurrei in the incidence of diphtheria.
Measles.
Alter a period of quiescence in 1921 the incidence ot measles commenced to
rise in the early part of 1922 and reached epidemic proportions in the months of March
and April. During the year 34,385 cases of measles were reported by the head
teachers as occurring among children attending the Council's schools.
"Unprotected" children were excluded from 249 class-rooms for periods
varying from a few days to three weeks.
Whooping
cough.
The number of cases of whooping cough reported in school children during 1922
was 10,340 as compared with 9,584 (1921), 8,779 (1920), 3,397 (1919), and 11,671
(1918).
Bingworm.
The decline in the number of ringworm cases recorded in 1921 was continued,
in a more marked degree, during 1922, 2,766 fresh cases having been reported for
the twelve months as compared with 3,473 in 1921 and 3,983 in 1920. At the end of
1922, 818 children were known to be suffering from ringworm as compared with 999
at the close of 1921. The number of children cured by X-Ray treatment at the
Council's treatment centres rose to 65 per cent. as compared with 60 per cent. in the
previous year. During 1922 the number of hair specimens examined in the laboratory
was 2,824, of which 1,448 (including re-examinations) proved to contain ringworm
fungus, 10 favus fungus and the remainder were free from disease.