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75
INFLUENZA
Immunisation.
The present position regarding this is that while the protection
conferred by immunisation is of brief duration (about 3-6 months) there
is a case for immunising certain groups of the population in whom a
contact of influenza might aggravate their disability or prove fatal. Such
groups include:—
(a) Chronic Lung disease, e.g. chronic bronchitis, asthma,
bronchiectasis, pulmonary tuberculosis.
(b) Chronic heart disease.
(c) Chronic kidney disease.
(d) Diabetes and possibly other endocrine disorders.
The only type of vaccine recommended is an inactivated influenza
A+B Saline vaccine, and it should be given during the early part of the
autumn.
TETANUS
The "first aid" prevention of tetanus is usually by the administration
of anti-tetanic serum. This is known to have certain disadvantages,
whereas the prophylactic use of tetanus toxoid either separately, or in the
combined form ("Triple" vaccine or Quadrillin) has no similar disadvantages.
Ideally, if a child known to be protected with tetanus toxoid
sustained an injury, all that should be necessary would be the administration
of a booster dose of tetanus toxoid. Unfortunately, too often, the
immunisation state of the child is unknown, at the time of the accident,
and anti-tetanic serum has to be given in the absence of this information.
2,997 children were given a primary course of immunisation against
tetanus and 890 were given a booster.
QUADRUPLE VACCINE TRIAL
During 1963 the Public Health Laboratory Service organised a trial in
eight centres in England and Wales to compare quadruple vaccine, Salk
and Sabin vaccine in their effect on the excretion of poliovirus after a
challenge dose of live attenuated poliovirus. The total number of children
required to take part was 240 and some 70 to 80 children were required
from the County of Middlesex. This was spread over the ten health areas
in the County and meant that six children in Harrow took part in the trial.
The proposed trial was carried out in children aged between six
months and two years who had not been immunised against poliomyelitis
or pertussis. One group of the children was given Quadrillin vaccine,
another group Salk vaccine and a third Sabin vaccine, and a fourth trial
group was not given poliovirus but was given a pertussis vaccine. The
vaccines were given in three doses at intervals of one month. The four
groups of children were given a challenge dose of living attenuated
Poliovirus type 1 three months after the last dose of vaccine and poliovirus
excretion was then investigated for six weeks.