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66.
Later, by arrangement with the Education Committee and the
Director of Education, pamphlets were given by head teachers to
all children attending the Infants and Junior Departments of
certain schools in the area. Owing to the limitation in the available
facilities, not more than one school could be circularised at a time.
Initial Test of Susceptibility.
Experience has shown that, whereas the great majority of
children under ten years of age are susceptible to diphtheria, the
majority of urban school children have acquired a natural immunity
towards the end of their school life. Therefore, in order to save
time and inconvenience, the preliminary Schick Test of susceptibility
has been omitted in children under ten years of ago unless the parents
have expressed a definite wish to have the preliminary test carried
out.
Protective Inoculations.
Whereas, until fairly recently, the best results were obtained by
three intramuscular injections of Toxoid-antitoxin Mixture (T.A.M.),
it is now recognised that equally good results may be obtained by
two intramuscular injections of Toxoid-antitoxin Floccules (T.A.F.).
In my last Annual Report I drew attention to the fact that preparations
of Alum-precipitated Toxoid (A.P.T.)—requiring only one
injection ("one-dose immunisation")—were now obtainable; but
that the material had not yet reached the stage of being available
for mass inoculation. Since that time larger supplies of Alumprecipitated
Toxin have been available, and during the year under
review opportunity has been taken of testing out this preparation.
It was found that the injection of alum-precipitated toxin was
followed by a hard nodular swelling at the site of injection, in some
cases by an area of inflammation. An additional consideration
which weighed against the more widespread use of A.P.T. was the
fact that, although it is known to produce immunity after one
injection, we do not know how long such immunity may last.
Under the circumstances it was considered advisable to use the
preparation which can be relied upon to give the maximum amount
of protection with the least amount of local and general reaction.
The preparation which has been in routine use throughout the
year at the Council's special clinics has been T.A.F., of which two
intramuscular injections are given, with an interval of four weeks
between the two inoculations,