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75
Schick Test and Active Immunisation against Diphtheria.
(1) Hospital.
During 1926 a commencement was made in Schick Testing the nursing staff and immunising
those nurses who proved to be susceptible to diphtheria. Since that date five cases of diphtheria
have occurred, one in 1927, one in 1928, one in 1929 and two in 1930. In three instances the attack
of the disease occurred in Schick positive nurses who had been immunised, but sufficient time had not
elapsed since the date of immunisation for full immunity to be established. Schick positive nurses
are not posted to the diphtheria wards until they have been at the hospital for at least six months.
This rule, however, cannot always be strictly adhered to, and consequently cases of diphtheria are
liable to occur in partially immunised nurses. In the other two cases the diagnosis of diphtheria is
open to question. Both occurred in immunised nurses who had been re-Schick tested with a negative
result 5 weeks and 8 days before the attack respectively. The clinical appearance of the throat was
suspicious in both cases. In one the first swab taken proved negative, but a second swab taken two
days later was reported positive. The other case proved to be a carrier and the tonsils had to be
excised before the condition cleared up. There is reasonable grounds, therefore, for suggesting that
this latter case was one of follicular tonsillitis occurring in a diphtheria carrier.
Nineteen cases of sore throat occurred during 1930 amongst Schick negative or immunised
nurses, and these all proved to be non-diphtheritic.

(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:—