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children treated by the general practitioners was 4,580, the grand total
of children treated under the three arrangements being 6,858. The effect
of national propaganda is shown by the fact that, whereas for each of
the first two months of the year the average number of children treated
was only 150, the figure rose for each of the next seven months to over
700.
The falling away in the number of consents was to be expected.
An encouraging feature is that the number treated each month at the
infant welfare centres has maintained a uniform level. Ideally the
number of children treated each year should be the number of births
for that year. Those dealt with at the infant welfare centres are treated
at the correct age in that they are protected before they have reached
the age at which their natural immunity passes off and before they are
exposed to greater risks of contracting infection. In surroundings such
as these, in these days when, because there is so little diphtheria, there
are reduced opportunities for the children to receive their sub-infective
doses which will help to raise the waning immunity, it is probably desirable
that those children treated round about their first birthday should, just
before their admission to school, receive a further boosting dose.
At the end of the year it was estimated that some 31-5 per cent, of
the children under fifteen in this district had been immunized against
diphtheria and 25-6 per cent, of those under five.
7,094 children were invited to be Schick-tested. Of the 3,216 who
attended both the test and the reading 97 were positive, a percentage of
3. As the Schick-test state of the children before inoculation was not
known, this cannot be accepted as indicating a 97 per cent, conversion
rate.
In December a child was admitted to hospital with a mild attack of
diphtheria. She had been immunized earlier in the year, receiving
0-1 c.c. A.P.T. on the 13th May and 0-3 c.c. on the 13th June. There is
no record that she was Schick-tested.
Provision of antitoxin.
45 lots were issued totalling 356,000 units. Almost invariably
when serum is given in private practice the dosage is 8,000 units. Very
few patients had been given serum before admission to hospital.
Schools and Diphtheria.
There were no cases this year in which there was any suggestion
that infection had been contracted in school.
SCARLET FEVER.
Incidence.
331 cases were notified during the year, amongst which were a few
which were errors of diagnosis. 326 cases is an incidence of — per
1,000 population, a rise on last year's rate but still lower than the
average for recent years (the local rates for the years 1934 to 1940 were
4.70, 3.47, 2.64, 2.31, 2.72, 1.60, 1.08) and lower than the average
for the country.