View report page

There can be little doubt that immunisation has been the prime
factor in this marked improvement. One would normally have
expected the hardships produced by the war and continued during
the post war years to have increased the diphtheria case and death
rates. The fact that this is not the case is surely a potent argument
in favour of immunisation. It is also pleasing to record that no
deaths from diphtheria have occurred in Southgate since 1943, and
that the last case of diphtheria reported in a Southgate child took
place in October, 1945.
If the present level of immunisation is maintained, and if we
continue our existing practice of immunising first at the age of 9—12
months, reinforcing the protection between the ages of 5—6 years,
and thereafter at 4—5 yearly intervals, diphtheria as a major killing
or even incapacitating factor should very largely disappear from our
midst. This is not to say that the older methods of hygienic control
such as isolation, supervision and exclusion of contacts and ' 'carriers,"
alleviation of overcrowding and disinfection should not be
continued. These play there separate parts, and must always form
the foundation upon which any preventive structure should be laid.
We can justly claim that Southgate was among the earliest pioneers
in the field of organised immunisation against diphtheria. Bearing
in mind the high cost of maintaining diphtheria cases in hospital,
the work has been fully justified on the score of economy alone.
With regard to immunisation against pertussis, it is too soon
yet to assess the results of our work. The available information on
the year's working of the special immunisation clinic against pertussis
and of the combined inoculations against pertussis and diphtheria
was made the subject of a special report which was submitted to
the Public Health Committee in January 1948. This report was also
sent to the Chief Medical Officer to the Ministry of Health, and was
the subject of a reply which congratulated Southgate upon its work
and gave us authority to continue. The conclusions set out in the
above-mentioned report may, with advantage, be restated. They
were as follows:
(a) The evidence available encourages one to the belief
that immunisation against pertussis either alone or combined
with diphtheria, does tend to modify an attack of pertussis,
should this occur.
(b) There is as yet no evidence that the incidence of pertussis
is less among the immunised than among the nonrmmunised.
50