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is, however, good clinical evidence that the severity of the attacks
is reduced very considerably. While the vaccine can be used
separately, it is usually combined with that against diphtheria.
During 1956, at least 684 children received primary courses
(333 at Infant Welfare Centres and 351 from private doctors) while
326 were given 'boosters', including 65 in the Centres.
TETANUS.
Of even more recent adoption officially, is a vaccine for
active immunisation against tetanus, and this is normally given in
combination with vaccines against diphtheria and whooping cough.
Tetanus immunisation was used effectively in the Services throughout
the last war and it has the advantages of not only producing
some immunity against undetected infections resulting from minor
injuries, but the necessity for using tetanus antitoxin following
gross injuries can be avoided. This is important as the horse
serum in the antitoxin contains antibodies which are apt to cause
serious reactions in a proportion of the recipients.
While tetanus is not such a common infection in Surrey as in
some Counties, its results are often very grave and, for the reasons
mentioned above, it would now appear wise to encourage the
wider inclusion of this vaccine in the combined vaccine which it is
the common practice to use for the primary immunisation of
babies.
TUBERCULOSIS.
In some Countries, very general use is being made of a vaccine
which it is claimed increases immunity against tuberculosis, but
here a much more guarded approach has been adopted pending
very careful observations of the results. For some years it has
been used to help protect close contacts of open cases of pulmonary
tuberculosis among the very young, nurses, etc., and in 1955
Ministerial approval was given to B.C.G. vaccine being offered
to the parents of children aged 13 years. Originally confined to
those attending Surrey County Council schools this treatment can
now be given to the same age group attending any school in the
District, and in fact 4 private schools have already co-operated.
In 1956, in this Division 64% of those offered treatment
accepted, of these 11% were shown by the Mantoux test not to
need B.C.G. vaccination and 53% of the age group were inoculated.
POLIOMYELITIS.
As is widely known, 1956 was the first year in which a vaccine
against poliomyelitis was introduced for use on a national scale in
this Country. Instead of limiting the initial trial to certain areas
as was done when trying out the whooping cough vaccines, the
registration of all children born between 1947 and 1954 whose
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