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confested, and there are still some persons who think that the disease
is caused by a virus and that the bacillus is only a secondary invader.
It is now acknowledged by most persons that the cause is a small
haemophilic bacillus called at first the Bordet-Gengou bacillus, now
generally known as Bacillus Haemophilus Pertussis. This is
mentioned because during the early summer, through the kindness
of Dr. Ian McLean working in the Inoculation Department of St.
Mary's Hospital, bacteriological examination of the sputum of early
whooping cough cases were examined, and a vaccine was used for
prophylactic purposes in the Day Nursery. Our figures are too small
for any statistical purposes, but it may be stated that in the few
cases which were examined and were found to contain the
haetmophylic bacillus, they subsequently developed the typical
whoop and a diagnosis was made on bacteriological grounds some
days before a clinical diagnosis could have been possible. The
bacteriological tests though, are expensive and elaborate, and it is
not practicable to carry them out as a routine, except in special
circumstances. The tests may be possible in the case of boarding
and private schools, but not in the elementary schools under present
conditions. Very extensive investigations have been carried out, in
fact, into the effect of vaccine treatment, but most of them have
been tried as curative and not as prophylactics. The curative effect
of the vaccine has in most cases been a failure, but prophylactic
injections have succeeded in attenuating an attack even when they
have not been completely successful in the entire prevention.
It is not easy to obtain plate cultures from young children,
As we found at the Day Nursery. Dr. McLean very kindly supplied
us with vaccine for prophylactic treatment at the Day Nursery,
and 16 children were treated by it. All the children had been in
contact with whooping cough. Two of the children had had only
one dose of the vaccine when the cough assumed the typical whoop,
and they did not have any more vaccine, but were excluded from
the Day Nursery. Two other children had only two doses each when
they left the Nursery. One of these had had a cough for some time
before receiving the first dose. The cough had not improved when
he left, and he developed the characteristic whoop after he left.
Twelve children received the full dose of six injections given at
intervals of three to four days and stretching over a period of 28
days. Not one of these developed a cough which could have been
diagnosed as whooping cough. Two of these had slight coughs when
they received their first injection; the cough persisted throughout
the period of 28 days, but it did not become spasmodic. One child
developed a slight cough after the first dose and another developed
a sight cough after receiving the fourth dose. The other six children
were quite free of coughs throughout the treatment and did not hive
whooping cough.