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45
Children over six were Schick tested before immunisation.
Owing to the very high percentage of positives at age six, only
those over seven are now tested. Out of 16 children aged six, only
one was negative. Of children of seven, one was negative out of
eight. Six out of 17 of those of ages eight and nine were negative
and 10 out of 26 of those of 10 and over.
105 children completed the course of three injections at
roughly weekly intervals. None have as yet been re-tested. A
few of the children of eight and over suffered from slight local
reactions but none below that age. One Schick positive child
had received one injection when she developed an attack of
diphtheria.
Bacteriological Examination.
663 diphtheria swabs were examined during the year at the
Essex County Public Health Laboratories and 321 at the Public
Health Offices.
Schools and Diphtheria.
The only instance where a definite school infection could he
traced was in a small infants' school which suffered in a similar
manner in 1929. The school, of an old type of building, contains
two classes in one of which three cases of diphtheria appeared,
one in one week and two in the following week. In this class
was a child with rhinorrhœa which contained the diphtheria
bacillus. On excluding him, no further eases appeared in that
school.
Of the 383 eases of diphtheria occurring through the year, 123
were primary cases in children who attended school. Of the
number, however, in 70 instances the case was the only one in that
department at that time, and was separated by more than one
week from another case of diphtheria in that department. Presumably
then, in these cases, infection of the patient was not caused
in the school. In 17 eases a child in the same department suffered
in the preceding week. This, however, does not. necessarily mean
the same class as many departments are run in as many as eight or
nine classes, completely separated, cach in its own room. In 15
instances there was more than one case in a department in the
same week, making a total of 36 children. 22 of these, however,
occurred two each in one department in the week. Three infections
in one week occurred in separate departments on three
occasions, and in one instance five children from a department
fell ill in one week.