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immunised. The response varies very much in different schools,
being very good in some, and not so good in others, but on the whole
steady progress is being made, and in some schools a very large
proportion of the children have been protected. In several of the
schools the proportion of children protected exceeds fifty per cent.,
and experience shows that where such a high percentage of the
children attending any school is immune, there is very little chance
of diphtheria spreading in the school. As a matter of fact only
five cases of diphtheria have occurred in all the infant and junior
departments during the year, that is in the departments in which
immunisation is carried out regularly, and these have all been
sporadic cases, not connected in any way with one another.
The total number of children who had received a full course
of injections at the end of 1933 was 1,951. Of this number 1,517
had been Schick-tested and found immune, five months after the
course of injections had been completed. 248 were awaiting the
final Schick-test, and 186 had failed to attend for test. These
figures are on the whole very satisfactory, and show that the work
is progressing steadily, if a little slowly. So far as the efficiency
of the immunisation is concerned it is still the case that no child
who has received a full course of injections, and after a negative
Schick-test been granted a certificate of successful immunisation,
has subsequently developed diphtheria. During the year three
children who had each received three protective injections were
sent to hospital with the diagnosis of diphtheria. Of these, E.H.,
5½ years had a course of injections in 1931. The Schick-test was
still positive, and further injections were recommended. These
were refused. In March, 1933 he had a bad attack of laryngeal
diphtheria and was in hospital for eight weeks. J. T., 5J years
had a course of injections in 1932, but did not attend when sent
for, for Schick-testing. In June, 1933 she was removed from a
general hospital outside this district to a neighbouring isolation
hospital as a case of nasal diphtheria. On arrival there, there was
no evidence of diphtheria found, and the diagnosis was not confirmed.
K.P., 2 years 8 months, had a course of injections in 1931, but the
Schick-test was still positive. After a second course the test became
negative. In August, 1933, she was sent to hospital with the
diagnosis of nasal diphtheria, but on arrival in hospital was found
to be suffering from Scarlet Fever, and no evidence of diphtheria
was discovered.
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