HEALTH NOTES.

Franklin Times, Volume XVII, Issue 73, 29 June 1927, Page 3

HEALTH NOTES.

DIPHTHERIA. MAKING GUILD REN IMMUNE, (Contributed by the Department of Health.) Diphtheria is caused by a .bacillus, discovered by Klebs in I<BB.'l, and cultured by Loc[Tier in IBBi. The disease does not arise” directly, from defective drainage and sanitation, though this may be a predisposing factor in that offensive gases lower the body’s resistance, making it easy for the germ to establish itself. The bacilli establish themselves in the throat or nose usually, and by swabbing patients-and contacts it is possible to isolate those who are likely to spread the disease, and so to cheek epidemics to some extent. Healthy people, adults or children, are found, especially in times of epidemic, who carry the organism to the throat- or nose without* having the disease. These “carriers” are also detected'by swabbing, and usually isolated till all bacilli have either disappeared under treatment or have been proved, by more extensive laboratory tests, to be non-virulent and harmless. Patients, contacts and carriers, during their period of isolation, should be avoided by all except those in attendance, the disease being spread from case or carrier to others. Some people, especially when the case is nursed at home, readily contravene ‘isolation instructions, and so the disease' easily finds new soil. Anyone having abnormal tonsils, adenoids, or nasal troubles accompanied by discharge, give the bacillus ready entrance, and is particularly liable to become a carrier or a case. Should the carrier state eventuate in such a person, the condition is apt to he stubborn, the best treatment being removal of the tonsils and adenoids. In any lliroat where these organs are enlarged or diseased, it is sound policy to have them removed, j In times of prevalence of diphtheria, * sore throats should he regarded with suspicion by parents, guardians or school teachers, and the family doctor called in to advise.' Sore throat with a passing indisposition of a day or so may in reality he mild diphtheria; though of such slight severity as to be missed unless watched for; and this type oT disease may damage the heart. Should such a mild case be missed, and allowed to return to school within a few days, other children will almost certainly be infected. Anti-Toxin.

The diphtheria bacillus, while living as a parasite in the nose or throat, forms a poison known as “toxin.” The bacillus itself, acting locally, causes soreness and the formation of a membrane on the tonsils spreading to the back of the throat, though such a membrane is not always formed. The toxin circulates in the blood stream, * damaging the tissues generally,, and causing such symptoms as fever and disordered heart action. The body, objecting to the presence of this toxin, forms “anti-toxin” to combat its effects. The severity of the attack and its ultimate conclusion depends on how successful is this anti-toxin counterattack. It has been possible to manufacture this anti-toxin, and to use it in helping patients in their struggle against the toxin of the disease. It is also used as a preventive, being given to contacts (people who have been exposed to infection) as a protection. Protection or “immunity” thus given is effective, but lasts only a short while, rarely more than three weeks, after which time the person -may contract the disease. .

A Better Method. Fortunately, a better and more lasting immunity can be produced by stimulating the body to manufacture its own anti-toxin. This is done by injecting a specially-prepared toxin into the body, when anti-toxin appears later 1n the blood. The presence of toxin acts not only as a stimulus to anti-toxin production, but also increases the body’s power of producing anti-toxin. Although this anti-toxin may later disappear from the blood, the power to produce it, and to produce. it rapidly, remains. Once the body has formed its own anti-toxin, there is ground for belief that it will continue to do so throughout life. The protection will certainly last through the danger period of school life. In practice, the toxin is mixed with a little anti-toxin, when it acts more efficiently. At least three injections of toxin-anti-toxin mixture are given beneath the skin of the arm, at weekly intervals. Immunity slowly ilbvelops, but may not be fully formed for three to six months. It is possible to determine after such an interval (six months)-whether the immunisation lias been successful, and a special test may be used for this purpose. In a very few cases three doses have not been enough; one or perhaps two further doses are given at I his time (six months after the original injections) to bring- about the desired immunity. Usually no ill-effects follow the injections in children, and there need be no absence from school or work. Epidemics would to a large extent be avoided and schools freed from the menace of diphtheria were this preventive measure freely made use of.

Protective Inoculation. The most dangerous age for a child to contract diphtheria is from two to five years. A child is naturally protected for about six months hv immunity handed down from I he mother. Thereafter this protection is lost, and parents should avail themselves of Lhe toxin-anti-toxin treatment described above. The best time is a I lhe age. of six months, when natural immunity begins to fail.. In London during the five years 1921-1925. of the total deaths from diphtheria, 57 per cent, occurred under five years of age. Why should parents consent to have their children protected against, diphtheria? Many do not worry much about the disease; should it occur, they depend on anti-toxin treatment to pull them through. Hut sometimes delay renders treatment ineffective. Evidence of diphtheria may he so slight that a physician is not called early enough. Or il may occur in the windpipe, causing- croup without sore throat, and advancing too far before

assistance is obtained. Anot^ l f" ininasal diphtheria, may be raided » a common cold until too late AP son contracting diphtheria must under ffo a period of illness, and whethci this he mild or severe, may sometime suffer bad after-effects, especially heart disorders. Other members the family are inconvenienced by ibo lation or quarantine repulati L « - by the disinfection of the Economically, the loss ma> 1 various countries children have been, and arc being, Ireatea in with toxin- anti - toxin. Khas proved itself safe. It is seldom that childicn under 10 notice any after-effects and wherever the use of toxm-anti-tox n has been systematically ' diphtheria has steadily dec. uued. When a child’s life may be al qtak Td when a simple proteci.cn is at hand, parents should cease t, take chances and avail themselves oi the immunitv readily established. In New Zealand during the last several thousands ot school child! t have been given this protective inoculation against diphtheria. In *BtneU where I his has been carried out. is beneficial results have been clearly cm-