View report page

53
In the light of this experience the practice is now to give an
initial dose of 0.1 c.c. A.P.T. followed in 14 days by 0.5 c.c. By
this method 97.8 per cent. are fully protected after one month and
99.1 per cent. after two months.
Fifty-five persons Schick negative after immunisation in previous
years—or naturally so—were re-tested during 1936. Three of
these were Schick positive after the original single dose of 0.5 c.c.
A.P.T. and two had lost their previous natural immunity.
Since commencing immunisation in March, 1932, and up to
December, 1936, a total of 592 persons has been found to be naturally
Schick negative and a total of 2,182 has been protected, a grand
total of 2,774, or 9 per cent. of the population under 14 years of
age as ascertained at the last census.
Immunisation by General Practitioners.—Diphtheria prophylactic
is available to general practitioners. During 1936,
19 c.c.s of alum precipitated toxoid and 4 c.c.s of toxoid anti-toxin
floccules were issued.
During the year several cases were reported amongst immunised
or naturally Schick negative children as having sore throats suggestive
of diphtheria. The routine in such cases has been for the
patients to be swabbed (a) for the presence of diphtheria bacilli,
and if found positive for a virulence test to be carried out, and
(b) for the presence of streptococci—particularly haemolytic
streptococci, and for a repeat posterior Schick test to be done.
Of these cases only one need be referred to as being suggestive
of clinical diphtheria. The notes are as follows:—
P.M., aged 7 years. 0.5 c.c.s A.P.T., 14.2.36. Schick
negative, 3.12.36. Sore throat, 26.2.36. Schick negative, 28.2.36,
Klebs-Loeffier bacillus present and virulent, haemolytic streptococci
also present.
Patient discharged from hospital in eleven days. Condition
gave rise to no anxiety.
Final diagnosis—either a mild case of diphtheria or more
probably streptococcal tonsillitis in a diphtheria carrier.
A second patient, J.K., aged 10 years, is of interest. She was
found to be Schick positive in January, 1934, and in view of previous
heart trouble, the parents were strongly advised to allow her to be
protected against diphtheria. They declined, and in September,