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41
Place of Treatment.
Six patients were treated in outside hospitals, five of them
being removed as in-patients and one as an out-patient from
London hospitals. One patient was treated at home, and the
remainder admitted to the Rayners Lane Isolation Hospital.
Deaths.
Three of the cases proved fatal, being a case mortality rate of
10 per cent.
Bacteriological Examination.
1,343 nose and throat swabs were examined for Klebs Loeffier
bacilli at the Rayners Lane Isolation Hospital during the year,
and 5 at the laboratories of the Clinical Research Association.
Immunization.
The same arrangements were continued as in the previous
year by which immunization against diphtheria was carried out
by the patients' own medical attendants. 315 children completed
the course of injections and a further 9 received one or more doses
after Schick-testing had proved them to be still susceptible after
they had been subjected to a previous course. T.A.M. is still being
used as antigen, three doses being given at two or three weeks'
interval. No "one-shot dose" antigen appears to give results
comparable in efficiency with this method, so no change has been
made. Of the 276 children Schick-tested subsequent to the course
of inoculations, 19 proved positive. Of those primarily Schicktested,
again none under the age of ten years were negative ; while
most of those even to the age of thirteen, were positive. This
high proportion of reactors is what might be expected in a district
which has been so free from diphtheria for a number of years. The
low level of herd immunity, which indicates the susceptible state
of the community, can be raised, in default of the occurrence of
cases, only by a greatly extended use of the facilities for artificial
immunization.
Provision of Anti-toxin.
Diphtheria anti-toxin is available free of charge to medical
practitioners for the treatment of necessitous patients. 18 lots
were issued during the year, totalling 248,000 units.
SCARLET FEVER.
Incidence.
423 cases of scarlet fever occurred during the year, a marked
fall on the figures for the previous year, being an incidence rate of
2.64 per 1,000 population, compared with the figure of 2.53 for the
country as a whole.