[Report 1950] / Medical Officer of Health, Burgess Hill U.D.C.

  • Burgess Hill (England). Urban District Council. nb2010028436.
Date:
1950
Catalogue details

Licence: Attribution 4.0 International (CC BY 4.0)

Credit: [Report 1950] / Medical Officer of Health, Burgess Hill U.D.C. Source: Wellcome Collection.

    4/18 (page 2)
    DIPHTHERIA IMIvIUNISATION. -2- Since July 194^ the County Council has been responsible for the administration of this Scheme and the County Medical Officer of Health has delegated the duties in connection with local arrangements to your Medical Officer of Health. Striking figures for the country as a whole were given in a recent article by a Medical Officer of the Ministry of Health. In 1941 over 50,000 cases of diphtheria vrere notified and of these 2,641 wore fatal, whilst for the preceding ten years the average annual nuraber of deaths was 3? 115 and that of notifications around 60,000. During 1950 the number of cases had fallen to 9^0 with 49 deaths and this satisfactory position has been maintained into 1951» Concern v;as expressed that in England and Wales during the latter half of 1950 there was a falling off in the number of children immunised and it was considered that this was due to the fear that inoculations might bring on paralytic poliomyelitis. This problem is now being investigated and for the present all that can bo said is that a prima facie case has been made out of the possibiD.ity, during the epidemic prevalence, of some occasional connection betv/oon recent immunisation and tho onset of tho paralysis Tho risk, nowover, is extremely small and in 1950 with over half a million immunisations only 58 cases of poliomyelitis developed within four weeks of tho injection, this, out of a total of 5000 cases of paralytic poliomyelitis. In this area investigations sinco 1947 have failed to shov; a single instance of paralytic poliomyelitis following imm.unisation injections. As it had been reported that tho occurrence of paralysis in tho limb had invariably occurred when tho injection v;as given intramuscularly it was decided in August to change our technique of giving .5 cc A.P.T. intramuscularly to ,5 cc P.T.A.P. subcutaneously because tho latter was reported to cause loss discomfort when given by this route. Our experience of this method has been sirailari in fact the reactions appear to bo less frequent and less pronoimcod and the Schick conversion rate is equally good. The falling off in iimmuni sat ions in tho country as a v;holc did not apply to this district and the position at 31st December, 1950 was that out of a total of 1985 children under 15 years of age, 1844 had boon immunised — a percentage of 93* Immunisation does not commence until tho child is nine months old and if these arc excluded from the figures the pcrcentc.gc of children immunised would be 98. I should like to emphasise once again that these figures arc not estimates but are founded on fact, a card being made out for every child in the district and immuni- sations are recorded thereon. As it is some years since the immunisation scheme as operated in this district was detailed I thinlc it may be helpful if I v/ore to explain our procedure. Details of children are received from vrerious sources including tho Registrar of Births (weekly return), the County Council through tho maternity and cliild welfare depart- ment, and other districts and schools. A loi/bor is sent to every parent when tho child is eight months old advising immunisation and giving the option of their own doctor or a special clinic. This letter is follov/cd by a personal approach by the district nurse or health visitor, and in a number of cases Dr, DiJco, Deputy Medical Officer of Health, gives the injections at tho child’s home. Three to six months after tho immunisation course, which consists of tv/o injections at monthly intervals, an offer is made to the parent for the child to bo Schick tested, and this is done by Dr. Duke at special clinics throughout tho district. As immunity wanes somewhat over 0. period of years all schooJ.s in tho area are visited at regular intervals, children in primo.ry schools being given a reinforcing injection on admission at the age of five years, while in the case of private school children the now admissions, of whatever age, arc Schick tested and only those found to be Schick positive are given another injection. At ton years of o-ge a Schick tost is given, and whore the tost is positive additional irmiunisation injections are given. With this ago group because of tho possibility of reactions with A.P.T, or P.T.A.P. the antigen used is T.A.F, It is interesting to note that of all children tested at this ago the percentage who arc positive is only 8, showing the methods adopted do ensure immunity among the majority of school children. It is also probable that those who do react to the Schick tost possess a latent imr.iunity v/hich would come into play if they wore infected with the organisms of diphtheria. All the testing and tost reading throughout tho ai\ hc.s been carried out ty Dr. H. L, D’jke, Deputy Medical Officer of Health, and he also gave the majority of uhe inoculations. It is mainly due to his efforts and those of Miss F.M.Dcan, Immunisation Clerk, that the scheme runs so smoothly and efficiently.