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practitioners were informed of the arrangements and invited to refer patients; the medical
director of the mass X-ray unit located at the East Islington welfare centre undertook to
draw the attention of persons visiting the unit to the advisory sessions and to distribute
requests for appointments to those interested; other referrals were expected from chest
clinics and self-referrals, although not sought, were accepted. Applicants attend the sessions
by appointment. A full-time medical officer attends the sessions regularly and assistance is
given by senior nursing staff, health visitors and social workers in the division. Dr. Freeman
and his staff and Dr. Wallace Craig, together with his colleagues, also participate actively
in the sessions. All new patients are received and interviewed by a doctor and most of them
are then referred to a series of group sessions.
As the sessions had run for less than two months by the end of the year it was too early
to give any reliable evaluation of results but the following figures in respect of the first
seven sessions to 31 December 1962 are of some interest:
No. offirst attendances 64 Total attendances. 256
No. attending
One session Two sessions Three sessions Four sessions Five sessions
64 36 25 10 1
Sources of referral
General practitioners 27 Self referrals 17
Chest clinics 5 Other (friends, relatives, television,
Mass radiography unit 5 health visitors)10
64
It is not intended to use the advisory sessions as a major part of the educational campaign
directed towards those who attend school. It is considered that this group should be tackled
primarily within the schools by the combined efforts of teachers and members of the school
health service. Apart from individual consultations in schools talks were given and films
shown in some of the senior schools but these efforts are still considerably handicapped by
the shortage of good visual aid material, especially of films of a technical standard
sufficiently high to hold the attention of such sophisticated audiences. The divisional
medical officer attended a meeting of the Islington Borough Youth Committee which
expressed a lively interest in propagating any efforts designed to curb juvenile smoking;
although all youth clubs in the borough were circulated, however, there was practically no
response.
Prophylaxis—The replacement of Salk vaccine by oral Sabin vaccine was welcomed;
staffing of poliomyelitis immunisation sessions was simplified and a series of special sessions,
including some in the early evenings, was arranged for adult workers. The initial response
from the public was good. Later, Press reports of restrictions on the use of live attenuated
virus vaccine in the United States and Canada had an adverse effect on attendances.
Although the use of Sabin vaccine continued there was no general publicity to sustain the
demand for immunisation by adults nor, fortunately, were there any poliomyelitis incidents
in the division. These factors were associated with a steady fall in the number of adults
seeking immunisation.
Meanwhile, a combined antigen was released which incorporates killed polio vaccine
together with diphtheria, tetanus and pertussis antigen. Such a vaccine may have attractive
advantages over the separate administration to infants and young children of triple antigen
and poliomyelitis vaccine. Trials of the quadruple vaccine commenced in divisions 3 and 6,
involving 100 children in each division, with the aim of assessing the effectiveness of the
vaccine by:
(a) determining the antibody response to the primary course and a booster dose;
(b) measuring the degree of intestinal immunity to polio virus and relating this to the
antibody level and
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