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INOCULATION AGAINST DIPHTHERIA.
This question of immunisation is a very complex one—
far more so than the general public have any conception of.
If the whole community were inoculated, especially children
under five years of age, you might certainly expect that
diphtheria, as a disease, would be banished from the country,
but nothing of the kind is likely to occur, there will be no
general desire for immunisation, and no law to compel it.
Official reports tells us that " The incomplete artificial
immunisation of a group may have no inhibiting effect on the
incidence of diphtheria " and may even increase the risk of
attack in the unprotected section of the community, by
increasing the carrier rate.
Diphtheria is spread in two ways—by those actually suffering
from the disease, and much more by carriers, that is
by persons who are found to have the active bacillus of
diphtheria (Klebs Loeffler) in their throats without any symptoms
of the disease. By all means let us have large families
and groups of children swabbed to ascertain the presence of
this noxious germ and have active treatment to eliminate it,
and immunise the others with or without a previous Schick
Test.
It is not known how long protection lasts after the inoculation,
it may be as long as ten years, in a few cases it does
not prevent an attack, though considerably modifying it.
We are all less susceptible to diphtheria as we grow
older.
In recent years the incidence of diphtheria has shown a
tendency to decrease, and one cannot be certain that the
alleged improvement in the mortality rate is really due to the
immunisation, especially as the large towns, where nothing
has been attempted, show a precisely similar drop in the
number of deaths!
In plain English I do not believe we can eradicate diphtheria
from our district, because we cannot carry out a campaign
of wholesale immunisation among the young people,
still less of the whole country.
At the moment therefore, whilst acknowledging that the
inoculation has an important place in " preventive " medicine,
I can only recommend that you provide the resident
medical practitioners with the toxoid anti-toxoid required for
the one dose and that you pay the fee agreed upon for those
people whose incomes come within the approved scale.
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