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IMMUNISATION against diphthEria.
During the year 1939 the routine employed in this
branch of preventive medicine has been considerably modified.
Up to September of this year all children over 5 years, and a
proportion of these under 5 years, were submitted to a Primary
Schick Test, those negative were discharged, and those positive
inoculated with one or other of the preparations, a final Schick
Test being performed two or three months later. This entailed
four or five visits to the Clinic. An analysis of the data,
provided by nearly six years of this work in Croydon, showed that
in Schools or areas where the incidence of diphtheria had been
low, in children over 10 year, less than 75 per cent would be
Schick positive; where the diphtheria incidence had been high,
in children over 8 years less than 75 per cent would be
positive; while in places where there had been a localized
outbreak, in children over 5 years, less than 50 per cent would
be positive.
Alum precipitated toxoid was used in 1938 and continued
during 1939. Of the 43 reactions 35 were mild and occurred after
the first injection; 8 were severe,- 7 after the first injection.
Of the 8 severe reactions, one occurred in a child of 5 years,
3 in children of 8 years, 3 in children of 9 years and 1 in a
child of 14 years.