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47
For the years 1916 to 1925 there were in each year some 50,000
cases of diphtheria in England and Wales, over 4,000 of these being fatal.
The average incidence for the ten years 1932 to 1942 was about 55,000,
of which 2,800 cases were fatal. There has been a steady fall each year
since 1943 by which time the immunisation campaign was well under way.
The number of deaths in any one year was below 100 for the first time in
1949; and the number of cases under a thousand for the first time in 1950.
In 1954 the number of deaths attributed to diphtheria for the first time
reached a single figure.
Immunisation
While thoughout the whole year those in touch with the parents of
small children urge the advantage of protecting the child against the risk
of contracting diphtheria, it has for some time been felt that the best
results would be obtained by carrying out a specially intensive campaign
extending over a few weeks, so that parents of small children for this period
would be receiving constant urging. This campaign is now held each
year in the spring so that the benefits of it can be obtained before the
rising incidence of poliomyelitis in the summer months might make it
desirable temporarily to discontinue the practice of immunisation.
A.P.T. continues to be the preparation most used, though P.T.A.P.
which is reported to be quite as effective and perhaps to be free from some
of the disadvantages of A.P.T., is now available. Many of the children
treated at the clinics are protected by the one preparation both against
diphtheria and against whooping cough. Because the County Council
has not yet adopted the principle of making arrangements available for the
immunising of children against whooping cough on the same lines as they
have in regard to diphtheria, it is not possible for the general medical
practitioners to obtain from the Public Health Laboratories free issues of
the combined preparations in the way they obtain supplies of diphtheria
antigen. In spite of this, large numbers of children are being protected
by their doctors by the injection of the one preparation both against
diphtheria and against whooping cough. In fact it is very probable
that it is the mother's fear of whooping cough and her desire to protect
her child from this which results in the still large numbers of children
being 8 protected against diphtheria. The very success of the diphtheria
immunisation campaign in virtually eradicating the disease has, by
removing the terror of the mother of this illness which she has not seen,
made it the more difficult to persuade her to have the child protected,
is most probable, if the single preparation did not protect against both
diseases.that the proportion of those who had been treated against
iphtheria would by this have fallen to an alarmingly low level.
During the year 2,312 children were treated for the first time, 1,115
general medical practitioners, and 1,197 at infant welfare centres.
number of births notified during the year was 2,755. It is estimated
that the end of the year 59.4 per cent. of children under five years
reprotected and 88 per cent. of children aged 5 to 15 years.
SCARLET FEVER
Today a very mild complaint, scarlet fever is one of the infections
witch has shown marked variations in virulence. In the earlier part of