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At the Evanston Hospital we have adopted the procedure of testing the nurses, when they enter training, for immunity to scarlet fever by means of the Dick test, and actively immunizing those giving a positive test by subcutaneous injections of the scarlet fever streptococcus toxin.
From March 1924 to October 1935, as shown in table 1, 439 nurses were tested and of this number 249, or 56.7 per cent, showed a positive Dick test and were given the injections of scarlet fever streptococcus toxin used to produce an active immunity.
The amount of toxin used to produce this immunity was gradually increased, by the Dicks, to a total of 115,500 skin test doses divided as follows: first dose 500 skin test doses, second dose 2,000, third dose 8,000, fourth dose 25,000, fifth dose 80,000. The second dose has four times the amount of toxin contained in the first, the third
RAPPAPORT B. ACTIVE IMMUNIZATION TO SCARLET FEVER WITH LESS REACTION. JAMA. 1936;106(13):1076–1078. doi:10.1001/jama.1936.02770130026008
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