HEALTH NOTES

Manawatu Standard, Volume XLVI, Issue 163, 11 June 1926, Page 9

HEALTH NOTES

DIPHTHERIA. DREAD DISEASIfoF CHILDHOOD MAKING CHILDREN IMMUNE Even to-day diphtheria is justly regarded as one of the most dreaded diseases of childhood, but in earlier years its appearance ■ in a community brought calamity and terror. Discussion and arguments w.ere waged as to its identity and causß, until in 1883 the special germ of the disease was discovered by Klebs, and in 1884 was grown in culture by Loeffler. When the enemy was thus detected and the plan of campaign revealed it became possible to fight it and nowadays there are few diseases concerning which we know as much as we do of diphtheria, or which we can attempt to prevent and control more hopefully. Yet even to-day diphtheria takes serious toll of a population. Thus in New Zealand for the last five years there have been 10,786 cases of diphtheria with 380 deaths. While diphtheria is present the whole year round, it is more common in winter months. It occurs more frequently among children than among adults, children under five years of age being most readily affected. Each new case of diphtheria is derived from a previous case or from a “diphtheria bacillus carrier” —that is, an apparently, well person who harbours the diphtheria germ in liis nose, mouth or throat. Tlie infection is caused either by direct contact, as by kissing or being sprayed with moisture thrown out in the act of Qoughing or sneezing, or indirectly through the agency of various objects such as pencils, apples, sweets, drinking cups and the like, which have been contaminated by infected persons. < SYMPTOAIS OF THE DISEASE.

While diphtheria may affect other regious of the body, the usual sites of the disease are the tonsils and throat, hence the most characteristic symptoms are sore throat accompanied by rapid pulse and fever, and .the formation of a membrane spreading over the throat. In the early stages the symptoms resemble those of a common cold, and as young children may not complain of sore throat it is necessary to realise that an apparently trivial illness may be the beginning of diphtheria/ and no time should be lost in calling medical advice. As the site of the disease is not invariably the throat, it does not necessarily follow that because there is no membrane on the throat there is no diphtheria. and for this reason also medical advice should be obtained in any suspected case. DIPHTHERIA ANTI-TOXIN.

There are few diseases, where early treatment is so efficacious and so fraught with hope as in diphtheria. There is no disease also in which early diagnosis and prompt treatment are more essential. We have at hand "a powerful antidote in the serum, commonly known as anti-toxin, one of the greatest triumphs or preventive medicine. Were it possible to apply this remedy in sufficient doses and early enough in all cases, mortality from diphtheria would almost vanish. As it is the disease has been robbed of most of its former terror.

Given in the early stages of the diseaso, diphtheria anti-toxin is a powerful weapon in cutting short the disease. Given to contacts, that is to say, people who have been exposed to infection from diphtheria, it affords a temporary protection against, it. Unfortunately this protection lasts only from two to three weeks, and leaves the individual at the end of that time as susceptible to the disease as ever. The chief • difficulty in the prevention of diphtheria has been the great number of healthy persons who carry bacilli in their throats. In the winter season, it has been found that more than one per cent of our population are diphtheria carriers. It is manifestly impossible to isolate such large numbers even if it. were not utterly hopeless and absurd to attempt even to examine the entire population in order to detect all carriers. These carriers transmit the disease in spite of all that has been previously done to prevent it and a susceptible person, especially a child, coming into association with a carrier, is likely to fall victim to diphtheria.

PROTECTION FROM DIPHTHERIA. In view of the fact, therefore, that children are necessarily exposed to the risk of infection from diphtheria it would obviously be an advantage were there any means of conferring upon them an immunity, that is, a permanent power of resistance to infection. Fortunately, the new means for dealing with the situation is now available. It is now possible to protect a child from diphtheria in the slame way as vaccination protects against smallpox. This may be done by giving him an injection of a vaccine (toxin anti-toxin) at weekly intervals for three weeks, which confers practically an absolute immunity to diphtheria. Thousands of children every year in England and America receive this treatment with the effect that the incidence of diphtheria is greatly lessened thereby. Preventive treatment for diphtheria by toxin anti-toxin had, until the last year, been carried out in only a few selected schools and orphanages in New Zealand. It was felt right, however, that the means of defence should be made more widely available. In certain areas where outbreaks of diphtheria have occurred frequently, therefore, meetings of parents were held last year and addressed by school medical officers on this question. Arrangements were made for children to receive immunisation. No.child was given immunisation without the written consent of the parent, treatment being in no way a compulsory one, as it appeared wiser to merely educate the public by administering the benefit of the treatment rather than to antagonise them by enforcing a measure which they did not fully comprehend. Approximately 1100 children were immunised during the period April to December last year. Except for a temporary slight illness, in a few cases treatment was carried out with little inconvenience. A satisfactory feature of the work was requests from several school committees that the children attending thenschools should have the benefit of treatment. . An important point in considering the preventive treatment for diphtheria by use of toxin anti-toxin is that the immunity obtained by this method is not conferred immediately, taking about three months to develop. It is not to be regarded, therefore, as an emergency measure for immediate use after exposure to infection. When there is any reason to suspect the presence of diphtheria in the house medical advice must be immediately obtained. This is necessary for the sake of the sufferer, as safety is mainly assured by the immediate use of anti-toxin, and it is also necessary for the sake of those brought into contact with the patient, who may lie given an immediate (though temporary) immunity by receiving antitoxin treatments.