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babies in early infancy, perhaps at this stage the body tissues would not
react to some of the other antigens. When these multiple preparations
are available, it is unlikely that many parents will not have their children
protected. In the meantime the steady campaign for inoculation against
diphtheria has run into difficulties. A few years ago it was recognised
in this country and in Australia that there was a higher rate of paralytic
poliomyelitis amongst those who had recently been inoculated to protect
them against certain diseases than amongst others in the population.
While this association was higher amongst those who had been given
whooping cough vaccine, it was also present to some extent in those
inoculated against diphtheria. A Committee of the Medical Research
Council investigated the matter, and found that the risk was substantially
greater when A.P.T. or a combined vaccine was used than when Formol
Toxoid was given. Because of this the use of A.P.T. and the combined
vaccine has been discontinued as a routine practice at the clinics. This
decision means that children will need to be given many more inoculations
if they are to be protected against these two complaints. Not all feel
that this step was necessary. If the decision merely resulted in the children
having a bigger number of injections, then no doubt it is the correct one;
but if it means that, because of the larger number of injections necessary
to protect children against whooping cough and against diphtheria,
parents decide against having the protection against both, this could
result in a substantial number being left unprotected against one of the
two diseases; if so, it would be more likely that this would be diphtheria.
If this should be the position, then more is lost than is gained by this
precautionary measure. However, as vaccine for protecting against the
risk of contracting poliomyelitis is available, it may be that the parents
of large numbers of infants will elect to have them protected so that to
them at least there would be little risk of provocation poliomyelitis and
they could be given the combined vaccine.
As a child is now not liable to be exposed to the diphtheria organism,
one who has been protected against diphtheria in infancy does not have
the repeated subliminal doses of infection required to keep up his protection
to the necessary level. It was customary then to advise that
children should have booster doses at different ages. It is now felt that
it is probably sufficient if a child has a booster dose just before he reaches
The age of five so that his protection is raised in time for him to meet
the added risk to which he is subject on going to school.
During the year 2,136 children were treated for the first time, 1,174
by general practitioners and 962 at the infant welfare centres. The number
of births notified during the year was 2,853. The aim should be that as
many children should be treated for the first time during the year as there
Were births. It is estimated that there were at the end of the year 62 per
of children under five years of age protected and 94 per cent, of
children aged 5 to 15 years. Booster doses were given to 926 children,
544 by general medical practitioners and 382 at the clinics.
SCARLET FEVER
76 cases of scarlet fever were notified in 1957. The rate per thousand
Population was 0.35; the corresponding rate for the country as a whole