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106
of the nursing and isolation in special hospitals of each case of
diphtheria averages £25 per patient.
Both the medical profession and parents realise that this disease
is not only costly from the point of view of expense to the community
as regards rates, but, even more important, is costly to
child life by reason of fatality, damage to health and interference
with school life and education. It can be definitely stated that
many thousands of children who have suffered from diphtheria are
partially handicapped for life.
This is truly a sad state of affairs, especially when we have at
hand a simple and harmless treatment which gives definite protection
against the disease. The Ministry of Health have, therefore,
in the Memorandum referred to above, directed the attention of
local authorities to the question in the following words:—
"It is, therefore, desirable that attention should be paid to the advantages
of diphtheria immunisation and 'where practicable to offer to the parents or
guardians of children of over one year of age the necessary facilities for
protection."
Sir George Newman, the Chief Medical Officer of the Ministry of
Health, has also said
" No local authority responsible for the health of children should be
satisfied that it has done its duty until every parent knows that his children
can be inoculated against diphtheria with safety and reasonable certainty of
complete protection."
Parents are inclined to think that normal, healthy children are
not liable to contract diphtheria—this is a fallacy and they are
running an unnecessary risk, when by a simple test it is possible to
ascertain for certain whether a child is liable to catch the disease.
If the test is "positive" the protective injections can be commenced
immediately.
The Hackney Borough Council established a Diphtheria
Immunisation Clinic at the Central Maternity and Child Welfare
Centre, No. 28, Lower Clapton Road, in January, 1928, and the
sixth year (1933) of the Clinic has been a record one, 1,033 new
cases having been treated, and as each child makes, on an average,
five attendances, the average attendance at each session has been 103.
I am informed that the child population of the Borough is
approximately 47,000, but so far only about 6 per cent. of this
number are known to be "naturally" immune or have received
certificates of immunity following a complete course of immunising
injections at the Clinic, and it has been demonstrated that the
incidence of and mortality from diphtheria are not appreciably
reduced until between 40 and 50 per cent. have been protected.