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49
Immunisation.
Under the provisions of the National Health Service Act the responsibility
for making available facilities for the public of the district
to be immunised is now that of the Middlesex County Council, as the
local health authority. The arrangements of the County Council by which
local medical practitioners carry out the work, were understood to be
independent of the general medical service. Immunisation was undertaken
by those doctors who entered into an agreement with the County
Council to do the work, whether or not they were taking part in the
general medical service. Up to the end of the year there were still no
signs of agreement on the question of the rate of remuneration of the
practitioners for this work. That was a factor, perhaps, which prevented
the numbers of those immunised rising to what is desirable. Ideally,
the number of children immunised against diphtheria for the first time
in any one year should be the same number as the number of births in
the preceding year.
Apart from the children who are treated by their own doctors, are
those who, attending the infant welfare centres, are treated there, and
those who are protected while they are at the day nurseries.
Of the 2,538 children who were treated for the first time during the
year 1,144 were treated by their own doctors, 1,380 at the infant welfare
centres, and 14 at the day nurseries. It was estimated at the end of the
year that 51 per cent, of the local children under the age of five years
were protected, and of these between five and fifteen years 69 per cent.
For immunising children A.P.T. is the accepted antigen, 0-5 c.c.
being given, followed by a similar dose in not less than one month's time.
Immunisation of infants is advocated at six to nine months of age.
Reinforcing doses should be given when the child attains the age of two,
again at the age of three and yet again before he is admitted to school.
For those who are likely to be sensitive, including adults, T.A.F. is
recommended as the most favourable antigen. These preparations can
be obtained by the medical practitioners free of cost from the Colindale
Laboratory or from the Public Health Office.
Provision of Anti-toxin.
The Regional Hospital Boards provide anti-toxin for issue to and
use by general practitioners. Supplies can be obtained free of cost from
Edgware Isolation Hospital or from the Public Health Office.
SCARLET FEVER
Incidence.
The incidence of the various infectious diseases varies. Some have
waves of epidemic prevalence. These might be of different natures.
Some diseases have shown secular, or long period changes of prevalence,
the wave lengths extending over many years. Some might show in
addition, and others show only, a periodic cycle with a periodicity of
months or years. Most infectious diseases again demonstrate a seasonal
prevalence, waves occurring on the longer waves at intervals of months.
The incidence of most, though not all of them, rises in autumn to fall
again in the spring.
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