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placed at my disposal I found very little difficulty in settling down. Some
extent to which co-operation between the nursing and clerical staff at the
Centre existed may be judged from the fact that it was possible for me to carry
out during a three-hour session from a minimum of 114 to a maximum of 212
immunisations and Schick tests.
In October, 1937, the Council opened another clinic at the Richmond Road
Centre, and the results from that clinic, together with those at the Lower
Clapton Road Centre, have constituted a record for any one year—1,835 new
cases. Such results can, I am sure, only be obtained by constant propaganda,
talks to mothers by the health visitors, film displays at the welfare centres,
the issue of leaflets to school children by the school authorities, the issue of
the "Birthday Wish" post-card, which, I understand, is sent by the Medical
Officer of Health to every child in the Borough on its first birthday, and the
many ways in which the Borough Council and the Medical Officer of Health
bring to the notice of parents the Borough Council's facilities for the protection
of their children against diphtheria.
Several medical practitioners have paid visits to the clinics to see the
technique of diphtheria immunisation prior to appointment to the Council's
panel, and any information they may have needed has been given to them.
During the year, 8 cases of children immunised against diphtheria were
reported as suffering from diphtheria. Each case was thoroughly investigated
and it was found that 6 of the cases were not suffering from diphtheria at all,
but had tonsillitis, and 2 had a very mild form of diphtheria with no clinical
signs, and were well again in a day or two. This definitely proves the high
efficiency and splendid results of diphtheria immunisation. Only four local
reactions from the immunising injections were reported during the year, and
these were only slight reactions and occurred in children between the ages of
8 and 11 years. To further eliminate the possibility of any local reaction such
as any slight soreness at the point of injection I have started giving this agegroup
a 0.75 c.c. of the immunising mixture instead of a full c.c. as a first
injection, and if this gave no reaction, a 1.25 c.c. as a second dose, with
1.5 c.c. as a third dose, as usual. This procedure has given very satisfying
results. All children over 11 years of age are given a desensitising dose of
0.25 c.c. as a first injection, and only if this small dose has given no reaction
is a full course of injections proceeded with.
Enteric Fever.—During the year under consideration 2 cases of
enteric fever and 4 cases of paratyphoid B fever were notified.
This shows an increase of 1 on the number of cases that occurred
during 1936. The attack-rate was 0.02 per 1,000 inhabitants,
compared with 0.05 for England and Wales.
All the cases were removed to hospital. There was one death
from this disease during the year.
One of the cases of paratyphoid fever notified was a girl, aged
15 years, who had arrived at a camp at Eastleigh, Hampshire, with
other refugee children from Bilbao, Spain. On the 27th May a
letter was received from the Medical Officer of Health of Eastleigh
stating that 400 of these children had been transferred on 26th May
to the Salvation Army Congress Hall, Linscott Road, Clapton, and