London's Pulse: Medical Officer of Health reports 1848-1972

View report page

London County Council 1957

[Report of the Medical Officer of Health for London County Council]

This page requires JavaScript

Table (ii) Whooping cough primary inoculations (including combined antigens)

YearNumber inoculatedPercentage immunised of live births
194925,93945.9
195017,33832.3
195111,35521.7
195222,23343.2
195322,71944.6
195437,43473.8
195527,94156.1
195636,55670.1
195735,65066.8

The amount of whooping cough immunisation performed in London since 1949
is shown in Table (ii). It is seen that there has been a substantial increase in whooping
cough immunisation since 1954, the comparatively low figure for 1955 being the result
of restriction of activity during the poliomyelitis epidemic of 1955.
Tetanus is an extremely serious and often fatal disease which in recent years has
become much less frequent, particularly in towns. The great success in preventing
tetanus in war wounds in the services during the last war by the routine immunisation
of personnel with tetanus toxoid demonstrated quite clearly the value of this method of
prevention. When one considers whether similar schemes should be provided for
civilians, the rarity of the disease and the apparent remoteness of infection at first suggest
that general immunisation would not be justified. When it is realised however, that a
substantial proportion of the population at some time in their lives sustain injuries for
which a prophylactic dose of tetanus antitoxin is given, the need for an alternative
method of preventing the disease appears more pressing. The advent of reliable combined
prophylactics with which it was possible to produce basic immunity to tetanus
at the same time as a child was being immunised against diphtheria and whooping cough
removed the need for separate injections of tetanus toxoid. In January, 1957, the Council
received the approval of the Ministry of Health to a scheme for immunisation of
children under five years of age against tetanus using the triple prophylactic. During
the year over 12,000 children were immunised in this way, nearly 30 per cent, of them
by general practitioners.
Tetanus
A matter that has been in the background of all immunisation practice during recent
years has been the possibility that immunising injections might in some cases be followed
by poliomyelitis. The subject was first raised in relation to cases of poliomyelitis in
London in 1949.* At the same time cases were reported in Australia and later the subject
was studied on a national scale in Britain. The situation in London in 1949 was reported
in detail in my annual report for 1952. As soon as the first cases were reported the
situation was studied and action taken. It was apparent that the number of cases of
poliomyelitis occurring was a minute fraction of the children being inoculated; nevertheless,
it did appear that in certain cases the injection had determined the site, and also
possibly the onset, of paralysis. There was no suggestion that infection with poliomyelitis
virus had been introduced by the injection. Nearly all the cases appeared to be
associated with the combined whooping cough and diphtheria prophylactic containing
alum.
Poliomyelitis
following
inoculations
Steps taken at that time were later shown to be abundantly justified. First a decision
was taken to cease using the combined alum prophylactic. Additional precautions were
* D. H. Geffen—1950 Medical Officer 1.137.
71