Diphtheria : problems in connection with the Schick test and active immunization / by R.A. O'Brien.

  • O'Brien, Richard Alfred, 1878-1970.
Date:
[1924?]
Catalogue details

Licence: In copyright

Credit: Diphtheria : problems in connection with the Schick test and active immunization / by R.A. O'Brien. Source: Wellcome Collection.

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    Phsvj /If [Excerpt from Vol. XLV., No. 3 (1924) of the Journal of The Royal Sanitary Institute.] Diphtheria : Problems in Connection with the Schick Test and Active Immuni¬ sation, by R. A. O’Brien, C.B.E., M.D., D.P.H., Wellcome Physio¬ logical Research Laboratories. I KNOW that at a meeting such as this, where we all are interested in public health, and well acquainted with all the latest achievements in this field of work, it is not to-day necessary for me to take up your time by presenting arguments in favour of the fundamental two propositions on which the more recent measures for combating diphtheria are based. These two propositions are : (1) that it is possible by means of the Schick test to discover those who are susceptible to diphtheria, and (2) when we have discovered them, it is possible by means of immunisation with preparations made from diphtheria toxin, to give these susceptible people prolonged protection against the disease. We may refresh our memories with a few charts setting forth the basal theory and practice of the measures we are to discuss. (Charts shown.) No serious observer who studies the results of the work that has been done by Park in New York, and his co-workers in other American States, by many workers in England, Austria, France, Germany, Holland, and in almost every civilised country in the world, has any longer any doubt of the general truth of the two propositions above-mentioned. From them it follows that any community has it in its power, if it decides that the work and expense are worth while, to reduce the incidence of diphtheria as completely as we can prevent or stamp out smallpox in an adequately vaccinated population. Two small tables may here be of interest; our own small figures, and the results obtained by Park and colleagues. Table I.—Results obtained by Dr. Park and colleagues in New York. Year. Total Cases. Total Deaths. Deaths per 100,000 1919 14,000 1,239 Population. 22 1920 14,100 1,045 21 1921 15,000 ... 891 ... 16 1922 10,000 876 15 1923 8,050 547 9*5 Table II.—Results obtained by Dr. O'Brien and colleagues in England. Schick Tests and Immunisation. Number Immunised and Retested, I' otal ... ... ... 3,903 Total ... ... ... 992 Number negative . ... 2,695 Per cent, negative after : Per cent, negative.. 71 8 weeks 90.2 Number positive... ... 1,208 12 weeks ... ... 98 20 weeks ... ... 99T From our experience we conclude that we can rapidly test a population of children—for it is amongst children that most diphtheria occurs, and where