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45
Bacteriological Examination.
461 diphtheria swabs were examined during the year at the
Essex County Public Health Laboratories, and 288 at the Public
Health Offices.
Schools and Diphtheria.
Schools again appeared to play no part in the dissemination
of this disease. Out of the number of cases notified, only 36
were in attendance at school. In only two instances did two cases
of diphtheria occur in the same department of any school within a
period of 10 days.
No schools were closed during the year on account of diphtheria
and no schools or school rooms fumigated.
Schick Testing and Immunization.
Sessions were held during the year at four different centres
in the district. Most of the new cases were obtained by circularising
the parents by issuing leaflets from the schools for the children to
take home. Immediately following the small outbreak previously
referred to, this school was again circularised with a gratifying
response; the results of most of these children dealt with however
will appear in the 1934 and not the 1933 returns. The success of
issue of forms in this way, in the absence of any local prevalence
of the disease, seems to depend entirely on the enthusiasm of the
head teacher for this line of treatment. Advantage is being
taken when sending the birthday cards to children at each age,
to include informatory leaflets and consent forms for diphtheria
immunization. This is undoubtedly resulting in a certain number
of applications. It is hoped that the cumulative effect of repeatedly
drawing the attention of the parents to the advantage of the
treatment will result in a satisfactory response.
A greater proportion of children now attend for their testing
after receiving the three doses. This is ascribed to the fact that
the present practice is that at the time of the giving of the final
dose, a leaflet is given to the child pointing out the advisability
having this test performed after the lapse of some months.
Immunizing doses are now being spaced at three-weekly
intervals. This procedure is more difficult from an administrative
Point of view, but is apparently justified by the small proportion