A DREAD DISEASE.

Hauraki Plains Gazette, Volume XXXVI, Issue 4883, 28 September 1925, Page 1

A DREAD DISEASE.

CONQUEST OF DIPHTHERIA, A SUBJECT OF INTEREST. “The Conquest of Diphtheria” was| the subject of an interesting and informative address given by Dr. P. Lynch, Pathologist and Bacteriologist, Wellington Hospital, at the Rotary Club luncheon. As diphtheria is most prevalent at this time of the year the subject naturally special attention, especially on the part of parents with young families, for the dread disease is peculiarly one of childhood.

Dr. Lynch said he had selected diphtheria as the subject of his remarks because of the widespread in* cidence of the disease in all countries, its relative high mortality, and also because it afforded probably the best example of close biological study of disease in all its aspects. COMBINED EFFORT.

The conquest of diphtheria, said Dr. Lynch, arose not from the efforts ct any one individual, but by the combined efforts of those who studied the disease from the purely clinical side, those who studied its bacteriology, and those who made clear to us the exact nature of toxin and anti-toxin, and finally the very excellent work which had been done, mostly in the last ten years, concerning natural immunity or resistance to the disease itself.

The speaker then referred to the important research work done by Bretonneau, Virchow, Kl.ebs, Loeffler, and Koch. The rod-shaped diphtheria bacillus had'been given the name ot the Klebs-Loeffler bacillus. Klebs held it to be the organism that produced the disease. In 1897 came the sensational discovery by von Behring of anti-toxin, and within a few months anti-toxin w,as being manufactured under the of many Governments.

In anti-toxin, said Dr. Lynch, we have a powerful weapon against diphtheria, for when used early, and in sufficiently • large doses, it reduces both the severity of the disease and its mortality, and similarly reduces the number of serious complications and after-effects which go hand in hand with the disease, PREVENTING THE DISEASE. Having discovered a suitable antitoxin, which gave brilliant results in the treatment of the disease, what was then to be looked for was some means of preventing the disease altogether. It wae found that certain people were entirely immune from the disease—i.e., that under no circumstances could they be infected. This was found to be due to the fact that some people had in their blood a certain amount of natural anti-toxin sufficient to render them immune or free from the possibility of infection. By means of a test which has become an everyday use it is now possible to tell whether any one person is immune from diphtheria or susceptible. This test goes under the name of the Schick test. The Schick test simply consists of the injection under the. skin of one-fiftieth of a unit of toxin. Should the patient’s blood* contain ‘sufficient of anti-toxin to render him immune from the disease no change ’..’ill follow. Should the patient be susceptible, within twenty-four hours, a zone of redness appears at the site of infection, which in three days is left as a pigmented scaling of the skin. Such people are referred to as Schick positive. It is found .that most children of a susceptible age (up to ten years) are Schick positive—i.e., very susceptible., to diphtheria—and this fact is borne out by the fact that hy far the greater portion of cases bf the disease are in children of these ages,

RENDERING CHILDREN IMMUNE, , However—ajid this is a point of great importance—there are , the means at our disposal by which Schiek-positive children may be rendered Schick negative, and consequently immune. This is by the administration at. three days’ intervals of toxin mixed with anti-toxin so that the anti-toxin is slightly in excess. After this/injection has been given the child remains immune to diphtheria for the rest of the danger period.

The obvious inference from this is that the child should b& Tendered immune. if one considers tthe relatively high incidence of diphtheria in this country and its relatively high mortality it seems well woirth the labour involved to clear the community of what is, still the most fatal of all the infectious diseases.

Dr. Zingher, who has been responsible for the introduction: of these’ preventive measures in New York City, makes the following suggestions : (1) Infants under six months t are unsuitable for immunisation; (’’2) children between six months and' flye years should all be immunised without the Schick test; (3) children of five years upon entering school' should all be immunised without the Schick test; (4)/ older children of fifteen years should only be immunised if the Schick test is positive ; (5) the same applies to children oyer fifteen years.