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an active immunity in children who must then continue to be liable to
contract this infection which is so very invasive. All that can be done
for the average child is to hope to avoid his being exposed to infection
in his early years, an attack in a child being usually much less serious than
in a baby or in an infant, and to take precautions, if the child is thought
to have been exposed to infection, so as to reduce the risk of secondary
infection if the attack of measles should develop. There is in gamma
globulin a preparation which is quite effective in protecting from and
more effective still in modifying an attack. As this is prepared from the
blood of those who have had the infection, supplies are limited, and must
therefore be reserved for special children, such as the child of under six
months who has been exposed to the disease and whose mother has
never had an attack of measles, or the exposed child of under two years
of age who is weakly, is suffering from some other illness, or is living
in a poor home.
WHOOPING COUGH
The incidence of whooping cough fluctuates most markedly. In
this district since the disease was first made notifiable in 1939 the range
has been from the 1,259 cases in 1941 to the 191 in 1949. The disease
is endemic in all temperate climates. There is a periodicity of two to
three years. Epidemics occur at any time of the year though more
commonly in cold or damp weather. The 211 cases in 1954 were fairly
evenly distributed throughout the year, the number in each of the
quarters being 59, 47, 48 and 59; there were no deaths. Nine patients
were removed to hospital.
With the relatively low incidence, few schools were at all heavily
attacked.
Much work has been and is being done on the preparation of a
vaccine to protect those treated from the risk of contracting whooping
cough. The result of the Medical Research Council enquiry into the
efficiency of the then preparations showed that they were effective, though
not to the same extent as the preparations used in immunisation against
diphtheria. It is probable that to-day's preparations are an advance on
those used in the enquiry. As yet the County Council has not made
arrangements for offering facilities to the public for children to be
immunised against whooping cough by their own doctors in the way
Hat they have for diphtheria. Many local practitioners, though, have
for years carried out this practice of immunising against whooping cough
either by preparations aimed at this disease only or more commonly by
the use of the combined antigen in which the one preparation confers
protection against whooping cough and against diphtheria. It is known
that 969 children were inoculated against whooping cough by their own
doctors This though, is probably far fewer than the number of
children actually treated At the infant welfare centres many children are
treated with the combined preparation aimed at whooping cough and
diphtheria In all during the year 2,175 children were immunised against
whooping cough for the first time. Of these 1,206 were treated at the
clinics.