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Infective Diseases. 27
injections and the full establishment of immunity, if exposure
to infection occurs. Parents should be warned on this point.
For the same reason, if immunisation is delayed until an epidemic
of Diphtheria occurs it may easily be carried out too late to prevent
infection.
Six children who have received at least three immunising
injections at the Centres have developed Diphtheria. As will
be seen from the particulars given below the attack in at least
four of the cases was a mild one. All of them recovered.
In cases Nos. 1 and 8 the attack of Diphtheria occurred before
immunity had developed. In case No. 2, although the retest
was negative a few days before the illness, immunity had
taken some nine months to develop, and the attack of Diphtheria
was so slight as to be almost negligible. In case No. 4, the attack
was a severe one and occurred 2 years after the immunising injections
had been given in a child who had not been re-tested.
In the other two cases the attack of Diphtheria developed more
than two years after the children had been immunised and had
re-acted negative to the Re-Schick Test.
Case No. 1.—A girl of IB—Schick Test positive—
received three doses of Toxoid Anti-toxin mixture at weekly
intervals—developed Diphtheria 2| months after the last
dose—this was a clinical case and the specific organism
was found on culture—the attack was a mild one—no
re-Schick Test was performed.
This child developed Diphtheria during the interval
required after immunisation for immunity to develop.
Case No. 2—A boy of 6—Schick Test positive—
received three doses of Toxoid Anti-toxin mixture—ReSchick
Test positive five months and negative nine months
after the last dose—Diphtheritic membrane and virulent
Klebs-Loeffler bacilli found in the throat 16 days after
the last Re-test was carried out—the child was ill for
only one day.
Case No. 8—A girl of 7—Schick Test positive—received
three doses of Toxoid Anti-toxin mixture—developed
Dipththeria five months and nine days after the last dose—