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36
It is now generally agreed that apart from active immunization,
no substantial reduction in the incidence and morbidity of the
disease can be expected.
At the second International Congress for Microbiology held
in London in July, 1936, some remarkable figures were given by
the readers of some of the papers. For instance, Hamilton, Ontario,
a city with 150,000 inhabitants was the first city of that size in
Canada to control diphtheria effectively. There have been no deaths
in Hamilton since 1930 and no cases since 1933. This record speaks
for itself. Other instances almost as striking were given.
No town in this country can be compared with this because
it is found difficult and even impossible to keep up the hard
immunity; immigration and apathy militate against our efforts to
keep up the immunity. In last year's report it was pointed out that
one of the dangers which we had to face was the comparative
freedom of the district from diphtheria. In the second half of 1936
only 2 cases of diphtheria occurred here; the parents become
apathetic and neglect to have their children immunized, and 1936
was one of our poorest in the matter of immunization.
It is impossible in the case of diphtheria to state what is
cause and effect. The recorded morbidity rates of diphtheria are
the resultant of different influences in different periods. But it is
significant that the lull in our immunization in 1936, was followed
by a sharp rise in the incidence of diphtheria in 1937. The following
table gives the number of children inoculated in the five years.
Under 5. 5—7 yrs. 7—15 yrs.
November 1932—December 1933 406 619 1678
1934 328 377 203
1935 284 393 62
1936 170 111 41
1937 333 340 33
In 1936, 246 children were Schick tested after six months
21 of whom were found to be positive and were given one more
dose; 262 were Schick tested after 3 years, 54 of whom were found
to be positive and were given one more dose. 382 were given one
more dose after 3 years without Schick testing.
In 1937, 241 children were Schick tested after 6 months and
of these 10 were positive and were given another dose. 401 children
were re-inoculated after 3 years.
We have altered our procedure several times since we began.
At the start we used T.A.M. or T.A.F. and gave three doses at the