View report page

Although immunisation in Wood Green is carried out by the
Middlesex County Council, this might be an opportune moment to
refer in some greater detail to our immunisation programme. During
1956, our policy was altered only in minor respects. Thus, we
decided to use the latest available type of diphtheria antigen
(formol toxoid), this antigen having proved both efficient and
safe. We also carried out most of our immunisation by the combined
method, i.e. pertussis (whooping cough) and diphtheria, thus limiting
the number of visits which mothers would have to pay to
clinics for the immunisation of their infants. We also found that
general practitioners were themselves immunising children in increasing
numbers, either against diphtheria alone, against diphtheria
and pertussis, or by the triple method, i.e. against
diphtheria, pertussis and tetanus. Incidentally, the County Council
scheme of inmunisation does not permit of the triple method being
used. This was the position at the end of 1956, although even by
that time we were beginning to become aware of certain difficulties.
What has transpired since belongs rightly to a future report.
It may, however, be stated briefly that an investigation carried
out by the Medical Research Council has shown conclusively that
immunisation by the combined method leaves the children so immunised
at greater risk of, contracting poliomyelitis than would otherwise
be the case. The risk is admittedly not great, but the fact
remains that immunisation by any combined method which contains
the pertussis antigen raises this issue. By the time this report
is written, we will have changed to the single type of inoculation
i.e. against diphtheria alone and against pertussis alone. General
practitioners have been advised of the new policy. This will obviously
entail more numerous visits to our clinics and to doctors'
surgeries where practitioners decide to adopt a similar procedure.
There will thus be added inconvenience so far as mothers are concerned.
We will await the results of our amended programme with
interest, if not with some apprehension. Portunately, it is hoped
that the Ministry of Health will shortly issue a statement which
will clarify the situation and may eventually allow us to resume
our previous policy.
Scarlet Fever
Seventeen cases of scarlet fever were notified during the year,
as against 26 cases in 1955 and 61 in 1954. From the number of
scarlet fever cases notified during the two previous years, i.e.
1953 and 1952 (66 and 93 respectively), it will be seen that
scarlet fever has declined progressively and substantially over
the past five years. This does not mean that scarlet fever is becoming
extinct. The whole character of this disease has altered
materially, so much so that what was once a very serious illness
now has seldom more than nuisance value. For this reason it may
well be that very mild cases-and there must be many such - pass
unnoticed. So long as scarlet fever maintains its present mild
character, there is no reason for alarm. As I have said several
times before, however, we must still assess the situation from
time to time, in order to make quite sure that the virulence which
formerly characterised scarlet fever is not returning.
31