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Diphtheria.—Thirty-one cases were notified, and of
these 19 occured in institutions. There was one death
of a child aged five years. The case rate was- 0'40 per
1,000 of population, compared with 114 for England
and Wales. The relatively small number of cases is
satisfactory, but should not be regarded with complacency
in the face of war-time risks of overcrowding
under domestic and shelter conditions.
As to the Prompt Use ot Antitoxin.—The prevention
of mortality from Diphtheria depends on early diagnosis
and early treatment. Responsibility rests on the
parents and on the medical practitioners. Parents
should call medical practitioners to sec suspected cases
at the earliest possible moment. Medical practitioners
should give large initial doses of Antitoxin on clinical
diagnosis and without waiting for bacteriological confirmation
of the diagnosis.
ARTIFICIAL IMMUNISATION ACAINST
DIPHTHERIA.
It was necessary to reduce the time devoted to this
service owing to the work of Air Raid Precautions,
but the service at the clinic was continued and 147
children received three injections of Toxoid Antitoxin
Floccules (T.A.F.).
Diphtheria is a dangerous disease and liable to epidemic
spread under the lowered hygienic standards
associated with war. Younger children are much more
susceptible than adults, and the mortality is highest
in the lower age groups.
Immunisation protects children against Diphtheria,
and all children should be immunised before they reach
school age. Parents are advised to have their younger
children immunised at once in order to protect each
child, each family, each school and the community
against the epidemic spread of the disease.
Pueperal Pyrexia.—Fifteen cases of Puerperal
Pyrexia were notified during the year. The case rate
26