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Diphtheria.
Although, as a result of immunisation, the incidence of diphtheria
had been falling progressively since 1934, the year 1950 was the first
in which there was complete freedom from this illness in the district.
It is gratifying to be able to report that 1951 maintained this record.
Provided immunisation can be sustained at a satisfactory level,
there is no reason why diphtheria should again be a public health problem.
The present freedom from this risk, however, carries with it its own
danger since it is difficult to maintain public interest in a preventive
measure in the absence of immediate threat. Although, immunisation
apart, diphtheria, like many other infections, is capable of showing
cycles of prevalence and virulence, there is no doubt that the intensive
work of immunisation during the past decade has been the deciding
factor in the present decline of diphtheria. It can be held in check
only by a high level of immunisation and any falling off in public response
will inevitably invite a return of this dangerous infection in significant
prevalence.
Diphtheria Immunisation.
The scheme for diphtheria immunisation, which is the responsibility
of the County Council, is by agreement directed by the Medical Office
of Health of the District Council. The arrangements were as described
in previous Reports, namely, facilities at the infant welfare and school
clinics and a programme of immunisation sessions held in the infant
and junior schools of the district in alternate terms. The object is to
secure initial treatment by the age of one year and to reinforce this by
further single injections before, or on entry to, school and thereafter
at three-year intervals until the child leaves the junior school. Under
this procedure the majority of children now receive initial treatment
in infancy and two or three reinforcing injections during school life.
The technique is to give two doses of 0.5 c.c. A.P.T. at one month's
interval for primary treatment and 0.2 c.c. A.P.T. or 1 c.c. T.A.F. for
reinforcing injections according to the age of the child.

A further 882 children received reinforcing injections in the area.
After allowing for transfers in and out of the district the figure for Carshalton
residents so treated was 854.
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