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demand. At present monthly sessions are held at Selsdon, Sanderstead
and Old Coulsdon with weekly sessions at Purley.
Similarly a very considerable amount of immunisation has been
carried out at the schools, particularly during the initial stages of the
Campaign in 1941 and 1942. Owing to the nature of the air attack and
to evacuation in 1944, followed by the demands on the Department at
the end of hostilities, and the movement of population occurring in
1945, very little was attempted during these two years, but an attempt
has been made in 1946 to increase the standard of immunity in the
schools, which is now thought to be reasonably satisfactory.
Two alterations in procedure which should be noted are the more
general use of the prophylactic material known as Alum Precipitated
Toxoid (A.P.T.), instead of Toxoid Anti-toxin Floccules (T.A.F.), the
use of which is now limited to older children and adults, and the introduction
of reinforcing doses, or "boosters," after an interval of 3-5
years has elapsed from the initial course of treatment or the administration
of a previous enhancing dose. The main advantages of the change
to A.P.T. are that only two doses are required at one month's interval,
thus reducing the inconvenience to the parent, the shock to the child,
and administrative work, together with the probable production of a
higher degree of immunity in a shorter period of time.
The introduction of the reinforcing dose, which it now appears
desirable to give usually at about the ages of five years and ten years,
has meant a very considerable increase in the administrative and clinical
work of the department, which increase will, of course, be of a permanent
character.
Since 1941 no charge has been made for the treatment of any child
residing in the District, but the children of persons residing outside the
District who apply for treatment and who are occasionally assisted in
this way are charged 12s. 6d. for the initial course.
Originally an attempt was made to Schick test all children about
3-6 months after the end of the initial course, but this standard, which is
not now recommended, had to be reduced and testing is now limited
to special cases or samples of the population.
The doctors practising in the District have been asked to co-operate
by forwarding information regarding the children who are immunised
privately and have recently been offered a notification fee, while they
can obtain supplies of the immunising agents either free or at cost price.
Actually very little information has been received from this source but
it is probable that only a small proportion of the immunisation in the
District is carried out in this way.
DIABETES.
Following the issue of the Ministry of Health Circular 2734, of 4th
January, 1943, the Council introduced a scheme for the supply of insulin
at reduced cost to those persons who are unable to obtain such supply
through other agencies under existing legislation. Only a few cases
have needed to be helped in this way and during 1945 four cases were
given assistance.
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