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51
It must be stressed that immunisation on the scale which is
current at present will only protect the individual immunised and
can only lessen the incidence of diphtheria in the community to a
very slight degree, if at all. It is stated that between thirty and
fifty per cent, of the pre-school population must be protected before
any marked lessening of the incidence of diphtheria can be
expected.
The experience of certain cities where immunisation has been
carried out on a wide scale is given below:—
City of Providence (U.S.A.): Population 271,000.—The
annual report for 1933 states that the last death of a resident from
diphtheria occurred in April, 1932. Some 50 per cent, of the
population aged 0—4 years and some 95 per cent, of those aged
5—14 years are protected. During the nine years 1924-1932 the
average number of cases of diphtheria per annum was 278.5 with
23.7 deaths. In 1933 there were 73 cases with 3 deaths. Of these,
19 cases were among non-residents who yielded all the fatalities.
St. Auburn (U.S.A.)—In 1920 the diphtheria mortality was
28 deaths per 100,000 and diphtheria immunisation was started,
and by 1924 85 per cent, of the children had been immunised.
From 1925 to 1930 there was not a single death from diphtheria
in St. Auburn.
In Hamilton, on Lake Ontario, with a population of 160,000
the mortality rate for eighteen years was twenty-four per 100,000.
Isolation, disinfection and detection of carriers were equally ineffective
dn controlling the disease. Immunisation of children
from one to fifteen years of age was begun in 1922. By 1927,
the local authority found that the diphtheria hospital had gone
out of use, and it was permanently closed.
Dick Tests.—52 children were tested, 13 being positive.
MUNICIPAL LABORATORY.

The total number of diphtheria specimens compares with 3,533
in 1933.