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Reactions to immunizing agents were few and slight. 18
children were reported as complaining after injections of T.A.M.
All followed the first injection except one which occurred after the
second dose. They were as follows: (1) Local and general—5,
where local redness with slight tenderness and a sensation of
malaise, and in one case axillary adenitis, were the features complained
of.
(2) Local—10, two of which were redness and swelling in the
arm persisting for 3 or 4 days, while 8 showed a mild reddening at
the site of injection at about 48 hours, and lasting for about one
day.
(3) General—3, in two of which the injection appeared to bring
on a typical attack of asthma (there had been previous asthma in
both, not noted before commencement of treatment), and in the
third an acute headache next day which cleared off within 24 hours.
It is perhaps of interest to note that 14 of the 18 cases occurred in
children over 7 and 4 in children of 5 and under.
One mother reacted unfavourably to her third dose of T.A.F.,
having an axillary adenitis; this may have been aggravated by
housework immediately after the injection.
7 Pseudo Reactions were noted as having occurred, none of
these being serious.
Intercurrent and Subsequent Diphtheria.
A family epidemic of Diphtheria occurring concurrently with
Immunization is of interest. J., aged 8, was Schick-tested and
found negative; S. and B., aged 5 and 6 respectively, were not
tested and received their first and second doses of T.A.M. W.,
aged 12, did not attend, though of school age, and was neither
Schick-tested nor given any injection. S. and B. attended for
their final dose and were found to have been suffering for 4 days
from what their mother described as "ulcerated throats."
Examination revealed typical diphtheritic membrane in each case,
without any apparent discomfort or evidence of toxaemia, though
in one child the membrane was already sloughing off one
tonsil. The two children were removed to hospital forthwith, and
Bacteriological examination showed in both the presence of the
Diphtheria Bacillus. The child J. was swabbed on several
occasions, and kept under strict observation, but was each time
reported negative and shewed no signs of contracting the disease.
W., however, developed Diphtheria within a few days and had a