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Diphtheria. The attack rate for Diphtheria continues to
below. The average for the past five years is only half that
for the previous five years. The average number of cases from
1934 to 1938 inclusive being 41 and the average for the years
1939—1943 inclusive only 21. The last two years' figures are
actually considerably below the average, being 16 for this
year and 15 for last year.
Diphtheria Immunisation. The facilities for Diphtheria
Immunisation were continued as in previous years. An attempt
has been made to expand the immunisation done privately by
general medical practitioners by extending the existing
facilities of free supply of material to payment for cases done.
The number of persons immunised at the Clinics, in schools
and by private practitioners is shown in Tables XIV, XV and
XVI.
There was one death from Diphtheria in a child aged
four years. The circumstances of this case presented some
interesting features. He was one of a family of ten children.
Of the seven children whose ages ranged between thirteen and
four months, the three youngest—aged respectively four
months, two years, and four years—had not been immunised.
David, the fatal case, aged four, was the eldest of these three
unimmunised children. The result of swabbing showed only
two positive contacts in the family, Bert aged 11 and Mary
aged 9. These were immunised children and were removed
to hospital. They were found, however, not to be suffering
from Clinical Diphtheria, in fact had no clinical signs of any
illness at all. The other children, including the unimmunised
William aged two were negative.
Eight days later George aged 5, who had had a negative
swab developed Diphtheria. He had been immunised a year
before. The family were again swabbed and all the others
found to be negative, including the unimmunised William
aged two.
At this stage with the second exposure, it was decided
to give William aged two a prophylactic dose of antitoxin.
George the immunised recovered though he suffered a
moderately severe attack. No other members of the family
contracted the disease.
At the stage where David the unimmunised succumbed
and his immunised brother and sister, Bert and Mary, though
showing the presence of the bacteria in the throat, presumably
from the same source, escaped, it looked like a triumph for
immunisation; but a week later when George, who was protected,
contracted the disease and William, the 2 year old,
though not protected had survived two contacts, it was clear
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