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In view of the persistence of diphtheria in London within recent years, the
application of the Schick test and active immunisation carried out in certain parts
of America and Great Britain are being watched with close interest.
Reference to the work which is being done on active immunisation against
diphtheria has been made from time to time in the annual reports and elsewhere.
The Council, on the 11th March, 1924, resolved that the Public Health and
Education Committees should consider and report whether or not the treatment
carried out by the department of health in New York City for rendering children
immune from diphtheria should be adopted in the London schools. An exhaustive
review of the subject was submitted to the Public Health Committee, who reported
to the Council on the 13th October, 1925, that inquiries were being conducted by
the Ministry of Health with regard to the immunisation of staffs at fever hospitals
and in connection with maternity and child welfare work, and that in their opinion
these lines of investigation should be thoroughly explored before further consideration
is given to the immunisation of children of school age. The Council concurred in
the views of the Public Health Committee and decided (13th October, 1925) that
the time was not ripe for the introduction of the Schick test into the Council's scheme
of medical treatment of school children.
The diagram on page 97 shows the mortality rates from diphtheria in
London, New York City and New York State (excluding New York City), and
it will be seen that, broadly speaking, the trend of mortality differs little in the
three areas.
Scarlet fever.
During 1925, 5,717 cases of scarlet fever were reported among children
attending the Council's schools as compared with 5,093 (1924), 4,824 (1923),
8,026 (1922), 17,030 (1921), 11,860 (1920).
Since the epidemic of 1920-22, the prevalence of scarlet fever has rapidly
declined and the annual returns of cases during the past three years were
considerably lower than the yearly average (6,744 cases) for the fourteen years
1906-1919, which preceded the 1920-22 epidemic, whereas in the case of diphtheria
the figures for the same years—viz., 5,033 (1925), 3,696 (1924) and 3,985 (1923),
were much higher than the annual average (2,846 cases) for the same pre-epidemic
period.
The following tabular statement illustrates the difference in the behaviour
of scarlet fever and diphtheria before, during and after the epidemic referred to.

The autumnal rise of scarlet fever in 1925 commenced about the middle of
September and reached its height in the third week of October. The geographical
distribution of the disease approximately coincided with that of diphtheria, the areas
chiefly concerned being those south of and bordering upon the river, whilst in the