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Schick Reactions and Serum Antitoxin Titrations on Children Injected with Diphtheria Formol Toxoid¹

International Health Division of the Rockefeller Foundation

Georg Pöch

Local Health Department, Eisenstadt, Austria

Abstract

The customary method of determining the effectiveness of diphtheria immunization by various antigens is the well known Schick skin test. This has been considered an indirect means of estimating a certain amount of antitoxin in the blood of individuals before and after injection with the antigen employed. Schick and Michaels (1913) stated that a negative Schick test should indicate an amount of antitoxin present in the blood serum of the subject under investigation not below 0.03 of a unit per cubic centimeter of serum (0.02 units per cubic centimeter of blood). This lower level of protection was later placed at 0.005 unit per cubic centimeter of serum (Schick, von Gröer, and Kassowitz, 1924) and in recent years 0.01 unit per cubic centimeter of serum has been considered sufficient to protect against diphtheria (Dudley, Surg. Capt. S. F., 1934). The so-called "Schick level" is now placed between 0.03 and 0.01 units.

Footnotes

¹ The studies and observations herein reported were conducted with the support and under the auspices of the International Health Division of the Rockefeller Foundation. The studies were made possible through the consent and approval of the Volksgesundheitsamt of the Austrian Ministry of Social Welfare.

The serological work was done by the State Serum Institute, Copenhagen, Denmark; Director Th. Madsen.