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22
Diphtheria, formerly one of the chief causes of death and
lifelong disability and a severe drain on public expenditure, has
responded so well to active measures of prevention by immunisation
that it has recently become a clinical rarity. During my first year
(1928) in Leyton there were 346 cases, of whom 18 died. The Leyton
Council's arrangements for diphtheria prevention by immunisation
were put into operation in February, 1935, and five years afterwards
(in the year 1940) it was possible to report—for the first time in
the history of the disease—that no child had died among the 55
who had contracted the disease during that year. The second
milestone on the road to diphtheria prevention was reached in 1949
when I was able to report that, for the first time in the Borough's
history, not a single case of diphtheria had occurred. Last year
(1950) I had the pleasure of recording a second successive year in
which no confirmed case had been notified. Unfortunately I am
unable to do "the hat trick" by recording a third clear year in
succession, for a girl of seven years spoiled the sequence by developing
clinical diphtheria in 1951. Unlike the majority of children of
her age, she had never been immunised against diphtheria. The
infection was mild, was not confirmed bacteriologically, and the
patient made an uninterrupted recovery; in fact there might have
been some justification for regarding it as a case of tonsillitis, but
the presence of a small patch of typical membrane on the throat
was sufficient on which to make a diagnosis of clinical diphtheria.
It is indeed a welcome turn in the tide of diphtheria incidence when
one case of such mildness can be of such statistical significance.
Information regarding Immunisation against Diphtheria is to
be found on page 87.