London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
Willesden 1929
[Report of the Medical Officer of Health for Willesden]
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72
Number of cases of Diphtheria occurring amongst probationer nurses during
1927, 1928 and 1929 (after immunisation was carried out) 3
Incidence rate (per annum) 3.3%
Number of nurses Schick Tested (1926, 1927, 1928 and 1929) 123
Number of nurses giving a positive reaction 60
Percentage of nurses giving a positive reaction 48.8%
Number of nurses re.Schick Tested 24
Number of nurses re.Schick Tested giving a positive reaction 10
Percentage of nurses re.Schick Tested giving a positive reaction 41.6%
Number of nurses who had to go off duty after an injection of toxin antitoxin 2
(2) Health Centre.
This clinic was first made available for Willesden residents in May, 1927, and consists of one
afternoon session per week at Health Centre 1, at which Schick Testing and Active Immunisation
against Diphtheria are carried out.
For the purpose of active immunisation against Diphtheria the population can be divided into
three classes:— (1) Children below school age. (2) School children. (3) Adults. The large majority
of the first class are susceptible to the disease with the exception of infants under one year. Accordingly,
it is not considered necessary to Schick Test these children prior to the immunising injections.
School children are given a preliminary Schick Test, and those giving a positive reaction are subsequently
immunised. It has been found unnecessary to perform the control test on this group, as so
few children give a pseudo.reaction. Adults, however, ought to have both the test and the control,
for a pseudo.reaction in an adult may indicate a subsequent reaction with the toxoid.antitoxin
mixture. In this case a preliminary dose of the mixture is necessary before the full dose is given.
The duration of the immunity has not yet been definitely ascertained, but the evidence
obtained, chiefly from American sources, shows that it lasts for about ten years. A child can,
accordingly, be protected during the most susceptible period of life, and until natural acquired
immunity is established.
The following are the figures for this clinic since its commencement:—
Table No. 49.— Preliminary Schick Test.
| Adults. | School Children. | |||
|---|---|---|---|---|
| Number Schicked | 13 | 1927—8 | 99 | 1927—74 |
| 1928—5 | 1928—23 | |||
| 1929—0 | 1929—2 | |||
| Positive Reactions | 10 | 1927—6 | 80 | 1927—61 |
| 1928-4 | 1928—17 | |||
| 1929—0 | 1929—2 | |||
| Negative Reactions | 3 | 1927—2 | 19 | 1927—13 |
| 1928—1 | 1928—6 | |||
| 1929—0 | 1929— 0 | |||
From this table it can be seen that the attendances for initial Schick Testing have now practically
ceased.
Table No. 50.— Active immunisation Injections.
| First Course. | Second Course. | ||
|---|---|---|---|
| Adults | 10 | 1927—6 | 3 |
| 1928—4 | |||
| 1929—0 | |||
| School Children | 88 | 1927—61 | 5 |
| 1928—25* | |||
| 1929—2 | |||
| Children under 5 | 39 | 1927—27 | 5 |
| 1928—5 | |||
| 1929—7 | |||
| * Includes eight school children in who, a preliminary Schick Test was not carried out. | |||
It will be noted that seven children under 5 years of age attended for immunisation injections,
compared with 5 in 1928 and 27 in 1927.