Before COVID-19...Diphtheria In Subiaco (1937).
Before COVID-19 there were regular outbreaks of diseases such as diphtheria, scarlet fever and tuberculosis in the early years of the colony.
The reports on the health of Subiaco and other municipal councils were published in the local newspapers. This included the name of the disease such as diphtheria, scarlet fever, Brill's disease and tuberculosis, who they affected and how they were spread.
In 1937, the West Australian newspaper reported on the total number and type of infectious diseases and deaths in the Subiaco Municipality... "A total of 154 cases of infectious disease, including six deaths, was reported for the year to October 31 last in the annual report of the chief health inspector of Subiaco municipality (Mr. A. C. Higgs). The incidence of the various diseases (with the corresponding figures for the previous year in parentheses) was as follows:-Diphtheria, 67 (36); tuberculosis, 28 (18), scarlet fever, 43 (16); Brill's disease, 5 (2); puerperal fever, 3 (5); ophthalmia, 1 (0); infantile paralysis, 1. (1); typhoid fever, 1 (0). The doubling of last year's total was attributed by the report to the large incidence of diphtheria and scarlet fever in May, June and July last. The cases were not confined to any particular locality or school, but were spread through the district..." (West Australian, 30 November, 1937).
A vaccine had been developed for diphtheria and the parents of children were encouraged to get their children vaccinated against the disease. At first the parents were resistant but after some publicity they were more inclined to get their children vaccinated. Health professionals argued that unless a large percentage of children were vaccinated there would be little effect against the spread of the disease.
An article in the West Australian titled "Diphtheria Menace. Immunisation Advocated" provides an overview of the history of the disease in the State in the previous years and in particular amongst children. The article describes health professionals advocating for state-wide, State Government funded vaccination programs for people and in particular children against the disease.
The articles are from Trove, the database of the National Library of Australia. No copyright infringement intended.
West Australian, 30 November 1937.
INFECTIOUS DISEASE. Incidence at Subiaco. A total of 154 cases of infectious disease, including six deaths, was reported for the year to October 31 last in the annual report of the chief health inspector of Subiaco municipality (Mr. A. C. Higgs). The incidence of the various diseases (with the corresponding figures for the previous year in parentheses) was as follows:-Diphtheria, 67 (36); tuberculosis, 28 (18), scarlet fever, 43 (16); Brill's disease, 5 (2); puerperal fever, 3 (5); ophthalmia, 1 (0); infantile paralysis, 1. (1); typhoid fever, 1 (0). The doubling of last year's total was attributed by the report to the large incidence of diphtheria and scarlet fever in May, June and July last. The cases were not confined to any particular locality or school, but were spread through the district.
The report continued: "This department was intensively active doing those things calculated to locate the origin of infection and check its spread. We took hundreds of swabs from contacts' throats and noses, in addition to swabbing the whole of the children from one large school. We enforced strict isolation, and thoroughly fumigated premises, furniture and personal effects, and in addition we advocated immunisation.
During this year a circular pointing out the advantages of immunisation against diphtheria was delivered to every house in the municipality, and as a result 300 children received treatment at the clinic at the Children's Hospita. This makes a total of 600 children of this municipality who have received immunisation treatment during the last two years."
West Australian, 15 May 1937.
DIPHTHERIA.
Subiaco Immunisation Campaign.
Having obtained reports on the subject from the medical officer of health (Dr. H. E. H. Ferguson) and the chief health officer (Mr. A. C. Higgs) the Subiaco Municipal Council has resolved to proceed more actively with the immunisation of children against diphtheria. A circular with an attachment to indicate the parent's consent is being prepared for immediate distribution in the municipality.
In the four weeks to May 4, nine cases of diphtheria, three of scarlet fever, two of Brill's disease and one of tuberculosis were reported in the municipality. The inspector found that three of the diphtheria cases were patients from an institution and one was a trainee from the same place. The Brill's disease cases were due to infection at a place of business outside the municipality.
His department had restricted the movements of all of the contacts, disinfected the premises and personal belongings of patients, and given advice on coping with infection. A joint report to the council by the medical officer and the inspector on the immunisation question shows that the disease is spread by a person suffering from the disease, or carrying it, coming in close contact with other people.
The greatest incidence is among schoolchildren who are in close association daily with their fellows. By a harmless inoculation, the children who are susceptible can be definitely protected by creating a condition of immunity or power to resist the attacks of the causative germ. As a result of publicity, about 350 children in the municipality have received the treatment at the Children's Hospital clinic, and 100 treated by private medical practitioners. However, in view of the large child population in the municipality, the total immunised is not considered enough to have any marked effect on the community.
Children of susceptible age come from other centres to reside in Subiaco, and there is in addition the natural increase. Consequently, states the report, in order to be effective, immunisation clinics should be constantly operating. When the council previously distributed literature on the subject, a proportion of parents were disinclined to have their children treated, but as a result of further publicity a number of those parents may now favour immunisation.
The chairman of the health committee (Cr. R. H. Nash) informed the last meeting of the council that the Children's Hospital was for the children throughout the State, and not specifically for Subiaco children, and therefore the question of creating a municipal immunisation clinic should be considered. Unless a high percentage of the child population was immunised, there would constantly be the menace of an outbreak of the disease in the municipality.
West Australian, 9 July 1936.
DIPHTHERIA MENACE. IMMUNISATION ADVOCATED.
State-wide Scheme Wanted.
Emphasising the need for a State-wide immunisation campaign against diphtheria yesterday, two Perth doctors said: -"We practice birth control in Western Australia but we do not look after the children we have got. Diphtheria is one disease that we can prevent.
State-wide immunisation would mean that deaths from diphtheria would be absolutely eliminated and cases would be practically abolished. Each year there are a large number of cases of diphtheria, and because this occurs every year we take no notice of it. Diphtheria is a menace to our people and should be wiped out. We have the means of doing it. Why not take advantage of it?
Diphtheria had been prevalent in some country areas and in sections of the metropolitan area during recent weeks, the doctors declared. Last year there were 1,308 cases in the State, the highest incidence for at least five years and probably for a very long period. In 1930 there were 1.045 cases, falling to 452 in the following year. A steady rise in each of the succeeding years culminated in an increase of nearly 350 cases in 1935 compared with the 1934 notifications. Deaths totalled 35 last year, 36 in 1934, 20 in both 1932 and 1931, and 43 in 1930.
"There is a scheme to spend varying amounts up to £60,000 on a new infectious diseases hospital at West Subiaco," said one doctor. "Between 65 and 70 per cent of the admissions to the infectious diseases hospital comprise diphtheria cases, and if a proportion of the money for the new hospital were spent on immunisation money and labour would be saved. In American cities which had a high diphtheria mortality rate immunisation has eliminated the disease. It will cost between £10,000 and £15,000 to immunise the whole State, but surely this would be worth while. The State-wide campaign should be sponsored by the State Government. Immunisation centres should be established, and if necessary a mobile unit used to enable populations remote from clinics to be immunised against diphtheria."
While immunity of the community against diphtheria was only partial the incidence of the disease would not drop, the other doctor interposed. "Immunity has, to proceed beyond 50 per cent of the, susceptible population before an adequate drop in the incidence occurs," he said. "The susceptible population comprises mainly children from two to seven years, but although adults have developed immunity from diphtheria, the probability of adults contracting the complaint is not remote. The most desirable period for the immunisation of children is at the pre-school age, from two to five years. A large proportion of the indifference to diphtheria immunisation is due to the fact that we possess a potent remedy for diphtheria-antitoxin. In spite of this treatment there is a steady mortality, but statistics do not express the long trail of after effects which diphtheria leaves in its wake-weakened hearts, paralysis, and the like. Immunisation of only a section of the community means that those people may become carriers of the most virulent diphtheria germs. Complete immunisation offers us complete immunity from diphtheria."
A clinic for immunisation against diphtheria, it was explained, had been established at the Children's Hospital by the board of management, which was fully seized with the importance and urgency of the work. Proper advantage had not been taken of the facilities provided. During the past three months the number of patients had barely averaged three per clinic. Owing to the poor attendances a certain amount of immunisation material had had to be discarded and much time and labour had been wasted. These disadvantages were small compared with the danger inherent in a partly immunised community with its increased number of virulent carriers and the certain risk of raising the general incidence of diphtheria.
Both doctors declared that the importance of preventive medicine could not be stressed too much. Treatment and the heavy costs it entailed would be obviated by establishing a State-wide immunisation campaign. A film was made available which should shed light on diphtheria and showed how immunisation was done. Possibly picture theatres could be induced to screen this film in an attempt to educate the people on the need for immunisation. The way was open for complete immunisation against diphtheria and no time should be lost. The State Government should consider what could be done in the interests of the people.
From the State Library of Western Australia. No copyright infringement intended.
Diphtheria immunisation continues at the clinic in Beaufort Street Perth 12 April 1950.
