Schick Test Research Articles

Diphtheria Prevention : The Schick Test and Active Immunisation with Toxin Antitoxin Mixture, by W. T. BENSON, M.D.,B.Sc.,D.P.H.,D.T.M. & H., Medical Superintendent, Edinburgh City Hospital. (Member.)

Diphtheria Prevention : The Schick Test and Active Immunisation with Toxin Antitoxin Mixture, by W. T. BENSON, M.D.,B.Sc.,D.P.H.,D.T.M. & H., Medical Superintendent, Edinburgh City Hospital. (Member.)

Results of Schick Tests in California

Results of Schick Tests in California

On the Susceptibility to Diphtheria (Schick Test Positive) with Reference to the Inheritance of Blood Groups

Abstract By means of the Schick reaction, we were able to distinguish, among human beings, those susceptible to diphtheria from the immune. The blood of the individuals having a negative Schick reaction contains normal antitoxin, and these are resistant to the infection. The origin of normal antitoxin has not been heretofore explained. Most investigators regard them as representing an acquired immunity. However, we meet with Schick negative individuals who have not had diphtheria. In these cases, the authors suppose that we are dealing with the effect of unrevealed infections. The following data seem to support this opinion. The countrymen are more often susceptible than town dwellers. The poor are more often immune than the rich. Children are more susceptible than grown-ups, girls more than boys. The authors explain this greater immunity of the poor and boys by their being more exposed to infection.

The destruction of rennin by agitation: A case of catalysis at an air-liquid interface

In a course of a series of investigations on the condition of maximum toxin formation byC. Diphtheria, undertaken by one of us (C. G. L. W.) (3), the question of “ripening” and of the deterioration of toxin in transport appeared to be colloidal phenomena in which interfacial action play a part. It was also noted that in the preparation of high dilutions of toxin for the Schick test great care is necessary when mixing the strong toxin with a diluent in order that no air bubbles passed through the solution. If this precaution was not taken the test fluid deteriorated in strength and led to untrustworthy results. Apart from the practical importance of the loss of strength of toxins, the process by which destruction was brought about was by no means clear, and it was considered of interest to investigate the phenomenon in more detail.

PROGRESS IN PEDIATRICS. REVIEW OF THE LITERATURE FOR 1923 ON INFANT FEEDING

<h3>BREAST FEEDING</h3> Kuttner and Ratner¹have undertaken to investigate the work of Theobald Smith to determine the essential nature of colostrum feeding in calves. These investigators were interested in its bearing on infant feeding. Smith showed that colostrum is not alone the chief means for transferring antibodies to the new-born calf. Colostrum also seems to have the important function of protecting the new-born animal against a general invasion by organisms of the<i>bacillus coli</i>group. With this in mind, Kuttner and Ratner sought for evidence of histologic differences in the placentas of various species. They used in their researches toxin, antitoxin and the Schick test as a means of control. There were some investigators who claimed that the placenta was impermeable to antibodies and that only through the milk was immunity transferred. In approaching this problem in human beings it was divided into two lines of study: (1) to

The influence of suprarenalectomy in rabbits on antitoxin (diphtheria) formation.

Previous reports by Také and Marine on hemolysin formation in suprarenalectomized rabbits and by Jaffe and Marine on agglutinin (typhoid) formation in suprarenalectomized rats have shown that both hemolysin and agglutinin formation are increased in suprarenalectomized animals. The antibody titer may be two or three times greater than in controls, using the same doses of antigen. It seemed desirable to test antitoxin formation also in suprarenalectomized animals. The method used consisted of injecting subcutaneously in the right flank the standard toxin-antitoxin mixture (1 cc. equals 0.1 L.+ dose) of the New York Board of Health furnished us through the courtesy of Prof. William H. Park. The Schick tests were made at weekly intervals, using in order the right lower, right upper, left lower and left upper abdomen as sites. The details and results are given in the preceding table. Of the 5 doubly suprarenalectomized rabbits which survived in good condition, 4 had negative Schick on the 21st day and one on the 28th day. Of the 7 controls, 4 were negative on the 28th day, 2 were still positive on the 28th day and one (492) was negative on the 18th day. It is noteworthy that this control showed a negative Schick earlier than any of the other rabbits and with less toxin-antitoxin. Nothing unusual in the clinical appearance of the rabbit was detected. It died about four months later while attempting ether anesthesia, and at necropsy acute dilatation of the heart with pulmonary edema and congestion were the prominent findings. With this exception it may be stated that the suprarenalectomized rabbits formed antitoxin as rapidly as, and in this series more rapidly than, the controls.

Further studies with the Dick test and active immunization with scarlet fever streptococcus toxin.

5. Retest of a group of children actively immunized with increasing doses of scarlet fever streptococcus toxin. 1. The application of the Dick test to a group of 320 children at the Horace Mann School and at the Riverdale Country School, New York City, has shown a very high percentage of susceptible individuals in this class of children coming from the more well-to-do homes. The test showed that of 320 children varying in age from 5 to 18 years, 266 or 83.0 per cent were susceptible and gave a positive reaction. The Dick test was also given to 80 nurses at St. Vincent's Hospital, and of these 42 or 52.5 per cent showed a positive reaction. The nurses at this hospital had been previously tested with the Schick test and 55 per cent were found susceptible to diphtheria. A group of babies were tested at the Heckscher Foundation with the following interesting results : Of a group of 4570 individuals varying in age from a few weeks to over 20 years we found that 1543 or 34.4 per cent gave a positive Dick reaction. Up to 6 months the percentage of positive reactions was 44.8; from 6 months to 3 years it ranged from 64 to 71 per cent; from 3 to 5 years between 46 to 56 per cent and from 5 to 20 years between 24 to 37 per cent.

The significance of the pseudoreaction in the Dick test and methods used for its identification.

Pseudoreactions due to the autolyzed streptococcus protein and other protein constituents of the toxin broth test fluid have an important bearing in the interpretation of the Dick reaction. Of 589 children tested in one of the public schools 459 were found to be immune. Of these, 190 or 41.4 per cent gave a pseudoreaction. Of the 130 susceptible children, 45 or 34.6 per cent gave a combined positive and pseudo reaction. Of another group of 950 children, who received the Dick test in two institutions, 686 were found to be immune. Of these, 232 or 33.8 per cent gave a pseudoreaction. Of the 264 non-immunes, 90 or 34.0 per cent gave a combined reaction. In children under 5 years the percentage of negative pseudo and positive combined reactions is much less and is closely analogous to the similar small percentages of pseudo reactions found with the Schick test in this age group. To make the readings of the Dick reactions more accurate and avoid the confusion that is very likely to arise between positive and negative pseudoreactions it is important to use a control test, which will show with a great deal of accuracy the difference between the four different reactions described before this society at its March meeting in connection with the Dick test: the positive, negative, negative pseudo and positive combined. The control test is thus closely analogous to the one used with the Schick test and serves the same purpose. It is even more important, however, to use a control with the Dick test than it is with the Schick test where it is strongly indicated in older children and adults. As the positive reactions appear within 24 hours the time element used by some to separate the positive and negative pseudoreactions in the Schick test is practically of little or no value in differentiating the reactions noted with the Dick test.

Results obtained with the Dick test in normal individuals and in acute and convalescent cases of scarlet fever.

Studies have been made with the Dick test among normal individuals along lines similar to those carried out with the Schick test. The susceptibility by age groups from birth to adult life has been investigated and found to correspond closely to the percentage susceptibility to diphtheria, as shown by the Schick test. Comparative studies have been made with the reaction on mothers and their offspring. The results indicate that the reactions are similar in the mother and offspring during the first six months of life. The antibodies are transmitted through the placenta and persist in most infants for a period of about six to nine months. The blood sera of individuals who gave positive or negative Dick reactions have been studied for their properties in causing the extinction test of Schultz-Charlton in a fresh scarlet fever rash; also for their power to neutralize the test fluid for the Dick reaction. The blood serum of a person giving a “negative” or a “pseudo” Dick reaction causes blanching of the rash and neutralizes the test toxin; that of a “positive or a combined” reaction causes no blanching of the rash and does not neutralize the test toxin. The Dick test is positive as a rule during the first two days of scarlet fever but becomes less positive toward the end of seven days and negative toward the end of ten to fifteen days, when the antitoxic properties begin to appear in the patient's serum. This can be shown by its power to blanch the scarlet fever rash and neutralize the Dick test toxin. The neutralization of the test toxin is a more delicate index of the presence of antibodies in a serum than its property to cause blanching of a scarlet fever rash.

Diphtheria : Problems in Connection with the Schick Test and Active Immunisation, by R. A. O'BRIEN, C.B.E., M.D., D.P.H., Wellcome Physiological Research Laboratories

Diphtheria : Problems in Connection with the Schick Test and Active Immunisation, by R. A. O'BRIEN, C.B.E., M.D., D.P.H., Wellcome Physiological Research Laboratories

The Schick Test and Immunisation in Fever Hospital Practice, by E. H. R. HARRIES, M.D. (State Med.) Lond. D.P.H., L'pool, Medical Superintendent City Hospital, Little Bromwich, Clinical Teacher of Fevers, University of Birmingham

The Schick Test and Immunisation in Fever Hospital Practice, by E. H. R. HARRIES, M.D. (State Med.) Lond. D.P.H., L'pool, Medical Superintendent City Hospital, Little Bromwich, Clinical Teacher of Fevers, University of Birmingham

A Report on an Outbreak of Diphtheria Involving the Use of the Schick Test: With a Note Appended

A Report on an Outbreak of Diphtheria Involving the Use of the Schick Test: With a Note Appended

THE SCHICK TEST AT THURSDAY ISLAND

Medical Journal of AustraliaVolume 1, Issue 5 p. 111-112 Original Article THE SCHICK TEST AT THURSDAY ISLAND A. J. Metcalfe M.B., Ch.M., A. J. Metcalfe M.B., Ch.M. Quarantine Officer Commonwealth Department of Health, Thursday IslandSearch for more papers by this author A. J. Metcalfe M.B., Ch.M., A. J. Metcalfe M.B., Ch.M. Quarantine Officer Commonwealth Department of Health, Thursday IslandSearch for more papers by this author First published: 01 February 1924 https://doi.org/10.5694/j.1326-5377.1924.tb65394.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume1, Issue5February 1924Pages 111-112 RelatedInformation

The Use of the Schick Test in a Boys' School

The Use of the Schick Test in a Boys' School

The Schick Test and Immunisation against Diphtheria, by DUNCAN FORBES, M.B.E., M.D., B.Sc., Medical Officer of Health, Brighton

The Schick Test and Immunisation against Diphtheria, by DUNCAN FORBES, M.B.E., M.D., B.Sc., Medical Officer of Health, Brighton

The Schick Test and the Medical Liberty League

The Schick Test and the Medical Liberty League

A CASE OF PHARYNGEAL DIPHTHERIA PROBABLY DUE TO AUTO-INFECTION FROM A DIPHTHERIC LESION OF THE THUMB

A physician, aged 30, a graduate student, gave a positive reaction to the Schick test, Oct. 10, 1922. There was a very slight pseudoreaction. There was no history of previous diphtheria. October 25, he carried out a virulence test with a culture from a known clinical case of diphtheria. At this date, he had not himself been in contact with a known clinical case for some time; nor had he been working with any other diphtheria cultures. While inoculating the guinea-pig, he pricked the skin on the dorsum of the terminal phalanx of the left thumb with the needle of a syringe containing the suspension from a twenty-four hour Loeffler slant. The suspension in the syringe was from a culture from the above mentioned case, and caused typical diphtheric lesions in the guinea-pig. October 29, the patient visited the laboratory and examined the inoculated animal, but after this date he

THE SCHICK TEST PERFORMED ON MORE THAN 150,000 CHILDREN IN PUBLIC AND PAROCHIAL SCHOOLS IN NEW YORK (MANHATTAN AND THE BRONX)

Performance of the Schick test and active immunization with toxinantitoxin were started on a large scale in the public schools of New York during the spring of 1921. Since then the work has been continued under the general direction of Dr. Park, and nearly all the children in public and parochial schools in Manhattan and the Bronx have been tested by myself and my group of assistants. In Brooklyn and Queens the work is being carried out by Dr. Schroder and her associates. The following report represents the tabulated summary of the Schick test on more than 150,000 schoolchildren in Manhattan and the Bronx. A. THE SCHICK TEST AND CONTROL TEST: DILUTIONS FOR THE TEST The Schick test was made on the right forearm of each child and the control test with heated toxin on the left forearm. The reactions were read from the third to the seventh day after

"THE INTRACUTANEOUS GUINEA-PIG TEST FOR HUMAN SUSCEPTIBILITY AND IMMUNITY TO DIPHTHERIA"

To the Editor: —The tendency to attach names to surgical procedures, to clinical phenomena and to various laboratory tests is exemplified by the second paper of Dr. W. H. Kellogg (The Journal, March 17, 1923, p. 748) describing a new test for immunity to diphtheria. This test is a modification of the old established method of Romer's for the intradermal demonstration in the guinea-pig of small amounts of diphtheria antitoxin contained in human serum. Ten years ago I used successfully a similar but more accurate modification of this test, which I described later (J. Infect. Dis.19:557 [Oct.] 1916). These antitoxin tests were made by me to establish some of the fundamental principles in the active immunization with toxin-antitoxin before Dr. Park and I introduced the Schick test as a part of the process of active immunization against diphtheria. We were only too glad to discard the routine use of

THE INTRACUTANEOUS GUINEA-PIG TEST (KELLOGG)

Since the publication of an article1describing a new test for the determination of immunity and susceptibility to diphtheria, opportunity has been afforded to check this method against the Schick test under a variety of conditions, and this experience with nearly 200 comparative tests prompts the offering of a second paper on the subject. Some of the results of parallel tests, and the conclusions reached, more properly form material for a discussion of the Schick test, because they pertain chiefly to experiences in the practical application of the latter. These observations will, therefore, be left for discussion elsewhere. The Kellogg test, for so it has come to be known for want of any other short appellation, is, briefly, the injection into the skin of a white guineapig of a mixture of equal parts of blood serum from the person tested and a toxin dilution containing one thirtieth of the