DIPHTHERIA

Evening Post, Volume CIX, Issue 91, 20 April 1925, Page 6

DIPHTHERIA

MAKING CHILDREN IMMUNE '.- .BRITISH AND AMERICAN REPORTS POSITION IN NEW ZEALAND. • Auburn, in the State of New York, is a small city, but it is in a small city that public health demonstrations can most easily be carried out to completeness. The vigorous campaigns conducted by Dr. E. W. Soars in Auburn for the past three years have .resulted in the raising of the proportion of diph■th'eria imniunes among the school children to 85 per cent. The effect has been to reduce the total cases of diphtheria .among, the school children from 85 per .school. year, to 3. The. most interesting phase of the work is that while the decrease of diphtheria among school children has had an overwhelming effect . ;.3n reducing infections among their you'n- • gor brothers and sisters, diphtheria in-' .ciden.ee-among the elders remains unchanged. It has long been possible, writes one medical authority, by means of antitoxin; .to render a. child immune to diph.thena,; temporarily, perhaps for a ■"month, or two, and great advantage has ■ been-taken of this to prevent the spread -oi..diphtheria in a family whec one of its members is attacked. Within two or three years, however, another preparation has been made, called toxinantitoxin, which renders this immunity permanent. Moreover, by a simple test, called the bchick test, which involves only a painless prick, of the skin of the arm with a needle, it is possible to separate those -■children -who-are susceptible to diphtheria from, .those who are immune to it. -Heretofore, methods of controlling diphtheria have been cumbersome, in.adequate,, and expensive. In past epidemics, it has been the custom, besides isolating diphtheria patients, to segregate those individuals found to be car,xiers of diphtheria bacilli. .As a definite proportion of the population are I carriers of the bacillus without any impairment of their general health, tnough ...*!\ c y.'.1?a.V be a source of infection 1o others, _ it_ ..is evident that the task of eliminating'all such carriers from the general ■ public is impracticable, and any attempt to do so would involve nothing short of dislocation'of the business lifs of. the community. Hence the desirability of utilising this latest means of rendering the population immune. PREVENTIVE.. CONTROL. In an address on. "Preventive Control -of Diphtheria,"- given before the Royal Society of Medicine, on 26th February, by Dr. W. Robertson, medical officer of ■health, Edinburgh, the speaker said that the-usual measures with regard to diphtheria had' rather the appearance of lock■in.g. the' stable door after the steed was stolen.-- He referred to the anxiety given to all Health Departments by the pi'Cs-encey.'df.' carriers.

Dr. Robertson described the methods adopted in Edinburgh to secure a systematic immunisation of the school population. Explanatory leaflets and consent forms were distributed to all scholars under the age of ten years. Parents were asked to consent to a- preliminary ._Schick testing; then, if necessary, three preventive Inoculations, " and a final Schick testing-.* The consent of parents vai-ied in different schools from 40 to SO per cent. -Tests showed that that passing through "an attack of diphtheria did . not confer a lasting immunity as judged from the Schick reaction. Experience had shown that in young children, aged 2 to 5, immunisation could properly be done without a preliminary Schick test. From the preventive point of view, said Dr. Robertson, it would be expedient ■to concentrate- attention upon children ■of pre-school age., It was essential, he ..added, that, -the method should, he applied" only by trained persons. ' ;■- After a- general discussion, the president, Dr. John M'Vail, tendered his congratulations and those of the State Medieuie Section, to Dr. Robertson, and added that.it was difficult.not to be envious of A'ew York; as shown by the success■tul. results obtained there. " Til his reply, Dr. Robertson said that Jn- a- school which had formerly <n"ven much trouble 110 cases had occurred amongst the immunised. .' BRITISH RESEARCH COUNCIL. The report of the British Medical Re- . *f-?}' eh ' Council-—a report compiled by a -group of seven bacteriologists—says •— . Among, young children (under five years ot age immunes are relatively rare, and tnus the Schich test may be regarded as superfluous. The injection of toxin-anti-toxin mixture produces antitoxin in the Wood or increases it if already present ■ in some cases a tenfold increase has been' obtained m a fortnight with one dose, it would appear that the immunity inchiced by injections of toxin-antitoxin is protracted, for there are few records of subjects becoming susceptible again after a successtul immunisation. This does not necessarily imply that the permanence is ■ fh\ \l -"Jepl -°y s alo»2- His possible that the natural immunising process has a large share 111 this effect, and that the primary stimulus of the injection renders «ie patient more susceptible to natural Jinmunisnig action. Some results recently published by Dr. Park on a mass offort carried out in New York showed lire number pf cases of, diphtheria reduced to one-four h_ amongst the inoculated, a Jesuit which is promising, since most of the immunisations were carried out. by methods which have since been aup J. scded by improvements in technique." Inc Department of Health M B says:—f'Mq argument should bo required to convince anyone of the value of this immunisation. It is peculiarly applicable to young children, for it is this -class-that -is most susceptible to diuhthena If all children of pre-school age could be immunised, in a few years diphtheria would be a rarer disease than smallpox, and not only many lives but much sorrow, worry, and expense would Ue saved to the community."

IN NEW ZEALAND HEALTH DEPARTMENT'S AIM. ' In New Zealand the Health Department has made use of the method of immunisation for some three or four years past. The first occasion on which the method was used extensively was at Ravensbourne School, Dmiedin". This school had shown a high incidence of diphtheria for several months, and it was decided that the best solution of the difficulty was to immunise all the pupils ■"at•the' school. This was done by the Department's school medical officers, and since then the disease has been practically absent from the school. .[ M addition, the Department immunised (he children at other institutional schools at .nnnadin: also at schools at Hamilton and iUmchison, which were at the time regarded as being in endemic areas. 1 he results in every case have been most encouraging, and indicate that in this method medical science lias a most valuable means of combatting diphtheria.' Ijic report of the bHeliTJologist who assMed in (he immunisation at TfainiKon indicates that t!ie results show Iliat the nMhcd has been very successful there: In further proof of Ihe recognition of (he v:.kn> nf tl;c method, il may be mentioned that some of the largest life in-

surance companies in America now advertise immunisation, and recommend the public to make us e of it as a sure defence against the disease.

In view of such overwhelming evi r dence, the Health Department is anxious to make the facilities for adopting it generally available, and it is, therefore desirable that parents should realise that there is at hand such a powerful weapon to combat this grave disease of childhood.