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Latent Infection with C. diphtheriae in Association with Bacterial Experience and Schick Immunity

Published online by Cambridge University Press:  15 May 2009

Sheldon F. Dudley
Sheldon F. Dudley
Affiliation:
Royal Naval Medical School, Greenwich.
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In a semi-closed institution, Greenwich Hospital School:

1. There was no constant relation between the prevalence of cases and carriers of virulent, or avirulent, diphtheria bacilli.

2. Carrier rates showed a seasonal periodicity with a maximum in the autumn and a minimum in the winter school term.

3. High rates for carriers of virulent bacilli were found in the absence of clinical diphtheria and presence of numerous Schick susceptibles.

4. As much as 40 per cent. of a random sample of healthy boys, none of whom contracted diphtheria, were discovered to harbour diphtheria bacilli (M.D.)1 within 1 year, during which the average carrier rate in the sample was 6·8 per cent.

5. The carrier rate for avirulent diphtheria bacilli, among boys recently infected with virulent, was three times the expected rate.

6. The carrier rate for virulent diphtheria bacilli, among boys recently infected with avirulent, was no higher than the expected rate.

7. The frequency of avirulent diphtheria bacilli infections was twice as great among Schick susceptibles as among Schick immunes.

8. Carriers of virulent bacilli (with five exceptions) were always found to have Schick-negative reactions, in spite of their being more frequent among the junior members of the institution.

9. Carriers of avirulent diphtheria bacilli were as common among the senior as the junior Schick-immune members of the school.

10. Carriers of avirulent bacilli were less frequently found in those Schick-susceptible members of the community who were most quickly immunised by artificial diphtheria antigens.

11. The hypothesis that, when a Schick susceptible is infected with virulent diphtheria bacilli, the latter often acquire avirulence, could satisfactorily explain many anomalies in the distribution of latent infection with diphtheria bacilli and Schick immunity.

[Since this article went to press I have received a reprint from A. Garrido-Morales and 0. Costa (“ The Mechanism of Natural Immunity to Diphtheria,” Amer. J. Hyg. (1931), 14, 89), who describe the distribution of diphtheria carrier infection and Schick immunity in a school at San Juan, Porto Rico. In the main their results parallel those obtained at G.H.S. The most important difference between the tropical and G.H.S. observations was found in a sample of children, who were Schick tested and swabbed synchronously, in which the frequency of virulent carrier infections was greater among Schick susceptibles than Schick immunes. (However, only 9 T.C.D. infections were found among 642 children, but 5 of these were discovered among the 194 Schick susceptibles in this group.)—S. F. D.]

Type
Research Article
Information
Journal of Hygiene , Volume 32 , Issue 2 , April 1932 , pp. 193 - 210
Copyright
Copyright © Cambridge University Press 1932

References

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