IV. INVESTIGATION OF C . DIPHTHERIAE
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epidemiological inquiry (compulsory : nasal and pharyngeal exudates) :
households, family, school and neighbourhood contacts.
(b) If one of the family members goes to another school or community,
the latter will also be checked.
(c) Swabs are collected in the morning before breakfast and before any
gargling and/or antibiotic treatment.
(d) Swabbing of the whole community is recommended as early as
possible after occurrence of the first cases on a large number of individuals
in the epidemic period, and simultaneously of the whole number of persons
established by the epidemiological inquiry.
3 . Immunological methods
(a) Checking of diphtherial antitoxin level in patients (less 0.03 AU)
to confirm diphtheria case (StBnicB et al., 1971).
(b) After the occurrence of the first cases, one should immediately check
the level of immunity of the susceptible age groups, below 18 years of age,
and adults in close contact with children, by means of the Schick test or
Jensen test.
(c) Vaccination of all Schick positive reactors, even of adults (teachers,
parents, etc.).
D. General recommendations for the organisation of a reference
1. A t any moment adequate quantities of the follouing material must be
available
diphtheria laboratory
(a) Sterile swabs introduced in sterile small tubes (12 x 120 mm).
(b) Sterile glassware, plates, plastic plates, pipettes, etc.
2. Equipment
(a) An optical microscope.
(b) A dissecting microscope or stereoscopic microscope.
(c) Platinum loops.
3 . Media
(a) Enrichment medium: ECST.
(b) Tinsdale’s base.
(c) Agar base for BA (blood agar) and CTBA (cystine-tellurite-blood
(d) Plain nutrient broth and 0.2% glucose broth.
(e) Tryptic digest broth (commercial).
(f) Agar base for EOF plates,
agar).
167
epidemiological inquiry (compulsory : nasal and pharyngeal exudates) :
households, family, school and neighbourhood contacts.
(b) If one of the family members goes to another school or community,
the latter will also be checked.
(c) Swabs are collected in the morning before breakfast and before any
gargling and/or antibiotic treatment.
(d) Swabbing of the whole community is recommended as early as
possible after occurrence of the first cases on a large number of individuals
in the epidemic period, and simultaneously of the whole number of persons
established by the epidemiological inquiry.
3 . Immunological methods
(a) Checking of diphtherial antitoxin level in patients (less 0.03 AU)
to confirm diphtheria case (StBnicB et al., 1971).
(b) After the occurrence of the first cases, one should immediately check
the level of immunity of the susceptible age groups, below 18 years of age,
and adults in close contact with children, by means of the Schick test or
Jensen test.
(c) Vaccination of all Schick positive reactors, even of adults (teachers,
parents, etc.).
D. General recommendations for the organisation of a reference
1. A t any moment adequate quantities of the follouing material must be
available
diphtheria laboratory
(a) Sterile swabs introduced in sterile small tubes (12 x 120 mm).
(b) Sterile glassware, plates, plastic plates, pipettes, etc.
2. Equipment
(a) An optical microscope.
(b) A dissecting microscope or stereoscopic microscope.
(c) Platinum loops.
3 . Media
(a) Enrichment medium: ECST.
(b) Tinsdale’s base.
(c) Agar base for BA (blood agar) and CTBA (cystine-tellurite-blood
(d) Plain nutrient broth and 0.2% glucose broth.
(e) Tryptic digest broth (commercial).
(f) Agar base for EOF plates,
agar).