Discussion on the modern control of infectious diseases / R.A. O'Brien.

  • O'Brien, Richard Alfred, 1878-1970.
Date:
[1926?]
Catalogue details

Licence: In copyright

Credit: Discussion on the modern control of infectious diseases / R.A. O'Brien. Source: Wellcome Collection.

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    P.tfiST [.Reprinted from the Proceedings of the Eoyal Society of Medicine, 1926, Vol. XIX (Section of Medicine), pp. 23—26\ m DISCUSSION ON THE MODERN CONTROL OF INFECTIOUS DISEASES. Dr. R. A. O’Brien. — * In my contribution to this discussion I propose to consider mainly diphtheria and scarlet fever. Attention has repeatedly been drawn to the fact that after the introduction of diphtheria antitoxin, about the year 1894-1895, a considerable drop in the mortality from diphtheria occurred, but that for many years past the incidence has remained fairly steady. Can the Schick test and active immunization help in reducing this incidence ? Table I records the figures for New York City and Chicago, where testing and immunization have been carried out on a large scale, with the help of a large number of public bodies, private societies interested in public health, and insurance companies. Table I.—Diphtheria Incidence, New York City and Chicago. Year Number of new cases reported Number of deaths Sctlck tested Number of persons immun¬ ized by T.A.T. (a) New York City ... 1919 ... 14,014 ... 1,239' ... 12,000 ... 5,150 ? 5 ’ * ’ 1920 ...‘ 14,166 ... 1,045 ... 20,000 8,000 (estimate) 5 5 * * 1921 ... 15,110 89 L ... 140,560 .. 42,000 i 1922 ... 10,427 873 ... 346,840 .. 48,496 f 5 5 * * 1923 ... 8,050 553 ... 119,493 .. 42,818 5 5 . . . 1924 ... 9,687 714 ... 130,493 .. 58,936 5~7 ‘ • 1925 ... 9,051 ... 663 ... 1 Average previous ten years 1,337. 83,854 .. 38,191 (b) Chicago 1922 ... 7,367 5642 ... 5,413 .. 8,396 5 5 * * * 1923 ... 5,836 366 ... 18,470 .. 28,378 5 5 * • * 1924 ... 3 672 216 23,296 .. 38,276 5 9 1925 ... 2,926 239 2 Average previous ten years 797. 21,579 . .. 45,282 “ In twenty-three representative American cities the death-rate since 1918 has fallen an average of 10'3 per cent, per year. This fall in the twenty-three cities studied by the Statistical Bureau of the Metropolitan Life Insurance Company has coincided with the general application of toxin-antitoxin immunization by city departments of health.” 1 The evidence that these measures have not merely been followed by the drop, but have been the main cause of the drop, though it may not even yet satisfy the rigid requirements of the statistician, will, I think, convince any ordinary observer who has followed the campaign throughout its history. 1 “ A Campaign Handbook for Local Tuberculosis and Public Health Associations,” State Committee on Tuberculosis and Public Health, New York City, No. 176,1926, p. 18.