View report page

three weeks after the second. In 1933 we revised the interval periods
and we now allow three weeks between the first and second dose and
4 weeks between the second and third dose.
In the first school which we visited both the infants' and the
junior departments were schick-tested. In the infants' department
S4.9 per cent, of the children were found to be schick-positive.
In the light of this experience we decided to immunize all children
under seven years of age without a preliminary Schick test, but
a posterior Schick test is done on children of all ages.
We have been fortunate in the absence of any marked reactions—local
or constitutional. In some cases the arms have become
red and swollen ; sometimes the swelling has reached as far
as the elbow. In every insrance swelling has completely disappeared
at the end of two or three days. In no instance have we heard of or
seen the swelling and redness persisting more than four days. In
only three cases did we know of any constitutional disturbance.
We saw two of these, and the disturbance was not sufficiently marked
to keep the children away from school. We did not see the third
child, as he was attended by his own doctor.
Because of the necessity of controlling the outbreak in the
schools we had to concentrate at first our attention very largely on
the children of school age. It was recognised though, that if preventive
measures are undertaken to stamp out diphtheria, it is
essential that a large proportion of the most susceptible children—
those of pre-school age—should be immunized. Since the summer
of 1933, we have concentrated our efforts upon the infants' departments
and the Infant Welfare Clinic, and the majority of the children
immunized in the autum of 1933 and the whole of 1934 have been
under 7 years of age.
We endeavour as far as possible to prevent the addition of
non-immune entrants to the infants' department, and so lower the
herd immunity. An immunizing clinic is held every Saturday
morning at the school clinic for children under school-age. The health
visitors distribute circulars to the mothers at the infants welfare
centres. The numbers on these Saturday mornings vary, the lowest
attendance being 9 and the highest 108.
At the beginning of each term, a list of the non-immunized
entrants is sent to the Headmistress of every infants' department,
who have greatly assisted us in obtaining consents. The head
teachers have not forgotten the sad results of the outbreak and are
convinced of the efficacy of our efforts.
In the spring of 1934, we were given some unsolicited publicity
which helped us considerably. The Anti-Vaccination League