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DIPHTHERIA:- Six cases were notified. The case rate was
0.08 per 1000 of population, compared with 0.58 per 1000 of
population for England and Wales. There were two deaths of
children aged 1 and 11 years from laryngeal infection and
cardiac failure. Neither had been immunised.
DIPHTHERIA IMMUNISATI0N:-In the past the mild or
intermediate types of the Diphtheria bacillus have been
dominant in this Borough, but the war-time movement of
population has led to a predominance of the gravis or severe
type with a corresponding increase in the gravity of the
illness.
The object of Diphtheria Immunisation is to prepare and
stimulate the natural protective mechanism of the body to repel
the invasion of Diphtheria bacilli and to neutralise their
poisons. This object has been largely attained against the
mild and intermediate types of the Diphtheria bacillus, but
experience has shown that the gravis type of the bacillus may
break through the barrier of immunity if this is not reinforced.
from time to time, and sustained at a high level. The
advantages of artificial immunisation are (1) that the risk
of acquiring infection is reduced (2) that if acquired the
illness tends to be modified and symptoms are less acute (3) the
response to treatment by antitoxin is more rapid (4) the risks
of mortality are greatly reduced.
Reinforcement of immunity can be obtained by a further
injection, and the following scheme of protection for children
is advised.
First injections at the age of 1 year.
Reinforcement injection at the age of 4 to 5 years.
Reinforcement injection at the age of 8 to 9 years.
During the period of evacuation there has been a definite
lag in progress of the immunisation scheme. This can only be
made good by the active co-operation of parents whose children
have missed immunisation. The probability of a higher
incidence of infection of the gravis type of Diphtheria bacillus
in the years during resettlement of the population is a grave
risk which requires the insurance against mortality provided
by immunisation.
Six hundred and forty three children were Immunised during
the year 1944, The number of children immunised at the age
of 1 year was 341 which represents only 29 per cent of the
babies reaching that age during the year, compared with 44 per
cent for this age group in the previous year.

At the end of the year 9,356 children, representing 62,1 per
cent of all the children, had been immunised. Of these 2214
represents 42.5 per cent of the children under five years of
age, and 7142 represents 72.5 per cent of the children between
five and fifteen years of age.
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