“ASSASSIN OF CHILDREN"

Evening Star, Issue 18628, 8 May 1924, Page 4

“ASSASSIN OF CHILDREN"

PREVENTION AND CURE OF DIPHTHERIA. POSITION IN NEW ZEALAND. ■Medical authorities in their work on diphtheria have found that not a single death from this disease need occur |1) if every child) bo protected against diphtheria by the proper administration of toxin-antitoxin on its first birthday ; (2) if the doctor is called m early when a child is sick; (3) if the diagnosis is made early; (4) if a sufficient amount of antitoxin is administered early. . , During the five-yearly period 1919-23 a total of 12,492 cases of diphtheria, corresponding to an average annual rate of 20.59 per 10,000 of the mean population, were reported to the Now Zealand Health Department. For the same period the deaths totalled 505, equal to an average annual rate of 0.83 per 10,000 of the mean population. Little progress has -been made in- the lost twenty years until quite recently to control this disease. The death rate from diphtheria for the quinquennium 18961900 was 0.78; in other words, the disease is apparently more fatal to-day than it was twenty years ago, notwithstanding recent discoveries of medical science. Diphtheria is, in the main, a disease of childhood. This fact is brought out clearly in the table below, which sets out the notifications and deaths by ago periods for the years 1920-22; —Diphtheria in Now Zealand. — Total Notifications and Deaths by Ago Groups for Period 1920-22. 0-5 Cases 1,744, deaths 137. 5-10 ... ’ Cases 2,310, deaths 88. 10-15 Cases 1,028, deaths 19. 15 and over ... Cases 1,960, deaths 25. If it be remembered that the age group 5-15 comprises the school population, and that children aged 0-5_ who contract diphtheria are frequently infected by brothers or sisters of school age, it is at once obvious that the school is the key of the situation. The next table is of considerable interest,. as showing the number and percentage of cases of diphtheria treated in public Hospitals during the period 22:Total Notifications and Proportions Thereof Treated in Public Hospitals for Period 1917-22.

The various figures quoted arc sufficient to show the importance of diphtheria both as a cause of mortality and morbidity. The amount of sickness and suffering caused by this disease is, in the mass, enormous! The interference with school attendance is as times considerable. The economic loss also is most serious, as can bo shown by a simple 'calculation, the average duration of stay in hospitals of such cases , and the average cost of maintenance while in hospital being known. The average duration of stay in hospital of diphtheria cases is four weeks. The average cost of maintenance is £2 per week. The cost of treatment in hospital of diphtheria cases for the period 1917-22 inclusive was therefore £2 multiplied by 15,541, multiplied by four equals, £124,328, or an average figure of £20,721 per annum. BLACK ENEMY OF CHILDHOOD. “Not so many years ago,” writes an American authority, “ diphtheria was the black enemy of childhood. All over the world it claimed a frightful toll. And the tragedy was that three quarters of its victims wore littlo tots under six—hardly more than babies. Swiftly it struck with deadly result—without warning—and there was no sure way to combat it. Then came antitoxin. Children who received this treatment at once enjoyed a better chance in their struggle for life. The diphtheria death rate was lowered. But antitoxin is effective only after diphtheria develops. It checks the progress of the disease, but it does not give lasting protection.

TRIUMPH OF MEDICAL SCIENCE. Now comes a great triumph of medical science—tho prevention of diphtheria. Today eminent specialists state positively and definitely that through modern preventive treatment diphtheria can bo stamped cut. Some children are able to resist the germs of diphtheria. Others are not. The wonderful discovery of Dr Schick, of Vienna, is now being used to show which children need protection—which are susceptible and which are not. The Schick tost consists in giving tho child a tiny injection in the skin of the arm. If, after a few days, a red spot appears where tho injection was made, the child is susceptible. If no spot appears, the child is immune.

Children who show by the vSchick test that they axe liable to diphtheria can be given at once the toxin-antitoxin preventive treatment. This treatment consists of three injections of toxin-antitoxin, one each week for three weeks. The Schick test does not make the child immune, but authorities agree that the toxin-antitoxin docs. Experience shows that both teat and treatment are painless and harmless. WHAT IS DIPHTHERIA? Diphtheria is the foremost fatal-disease in children from three to five years of age. Diphtheria is a highly-contagious, or catching, disease, and is caused by a germ. It is spread by contact with a person who has virulent diphtheria germs in his noso or throat. DIPHTHERIA CARRIERS. There is another class of people known as carriers. They aro persons who are immune to their own germs; but if the germs are passed on to another person who has little or no resistance the person in contact may collect the germs and contract the disease. The diphtheria carrier is the most fruitful source of spreading diphtheria. In groups of children, such as in schools whore there have been no cases of recent diphtheria, it is found that two out of every 100 children have diphtheria genus in the throat, and may run as high as ten out of every 100 in groups whore there have been recent cases of diphtheria. As in diphtheria, diphtheria carriers are diagnosed by nose and throat cultures. OTHER SOURCES OF INFECTION. Diphtheria may also be spread by milk if same is not pasteurised. Someone who harbors a virulent type of these germs may contaminate the milk by the spray from his nose or throat,* or with his hands or fingers soiled with secretions from nose or mouth. Occasionally the gems may attach themselves to clothing, bedding, eating utensils, etc,, and thus be carried on to a susceptible person, and cause a case of diphtheria. TREATMENT. Prior to 1896, when a sickness was diagnosed as diphtheria it usually meant death. In 1890 antitoxin as a cure for diphtheria was introduced. It was one of the most remarkable discoveries in medicine. As soon as diphtheria antitoxin became generally accepted and used as the proper treatment for diphtheria the death rate began to fall, and has remained low as compared with the period prior to 1896. To-day it is known that there Is but one curative treatment for diphtheria, and that is antitoxin. Not only is the antitoxin of importance, but also the time of administration and the amount given affects immediately the result. It has been shown that if antitoxin is administered early—that is, within the first twelve hours, and in sufficient dosage—there will not be one death from diphtheria. Diphtheria antitoxin is also of value in protecting persons exposed to active cases of diphtheria. Its action is immediate. Diphtheria antitoxin is not harmful or injurious in any jray.

IMMUNITY AGAINST DIPHTHERIA Greater than the discovery of antitoxin are the methods provided by medical science to protect the young and old against the ravages of diphtheria by means of diphtheria toxin-antitoxin immunisation. Toxin-antitoxin is a serum composed of diphtheria poison, almost; neutralised by diphtheria antitoxin,' and is capable of stimulating : tlie production of more anti-: toxin. Its results ..fill one of tho most brilliant pages of medical history. The method is' safe", 'sure," and' simple. It"ia‘ an absolute protection against diphtheria provided that it is administered until a negative. Schick test is produced. The duration of tho protection against diphtheria is for not loss than six years and probably for life. Toxin-antitoxin should bo given to every susceptible child from one to twelve years of age. Giving ioxin-anti-toxin to school childrennot only acts to prevent their contracting diphtheria, but also lessens the exposure of children of pre-school age to active oases of dihptherin in their families. In America tho work of diphtheria immunisation in schools is restricted to the children in the kindergarten and first grade classes. Only children are given this protective treatment whoso parents consent. SUMMARY. 1. Diphtheria is preventable. 2. All children under fourteen years of age should bo tested for susceptibility to diphtheria. o. Have your children of the ages of from one to fourteen years who show susceptibility to diphtheria immunised against diphtheria. 4. Toxin-antitoxin is tho 100 per cent, preventive of diphtheria. STEPS IN NEW ZEALAND. Tlie New Zealand Department of Health lias been keeping in close touch with these latest developments, and has, indeed,’ made trial of tho methods outlined above. Tlie earliest adoption of those methods in New Zealand, so far as is known, were in 1919, when the Health Department immunised in this way the residents of an institutional school in which diphtheria had been endemic for some time. Since then the method has been used for tho immunisation of one school in a suburb of Dunedin and two schools in Hamilton. The results have in each case been most encouraging. The Health Department is desirous of pressing on with tins phase of its work, and hopes in the near future to be able to offer to the school population in all parts of the dominion this method of protection against a most formidable disease.

Cases Cases Year. notified. treated. Percentage. 1917 ... 5,458 4.122 75.5 1918 6,539 4.430 80.0 1919 ... 3,499 2,221 63.5 1920 ... 2,442 1,669 68.3 1921 2,611 1,723 66.0 1922 ... li989 1.377 69.2 Totals 21,538 15,541 70.4'