Schick test

This is an acute, non-invasive infectious disease associated with the upper respiratory tract (Chapter 7). The incubation period is from 2 to 5 days although the disease remains communicable for up to 4 weeks. A low molecular weight toxin is produced which affects myocardium, nervous and adrenal tissues. Death results in 3-5% of infected children. Diphtheria immunization protects by stimulating the production of an antitoxin. This antitoxin will protect against the disease but not against infection of the respiratory tract. The immunogen is a toxoid, prepared by formaldehyde treatment of the purified toxin (Chapter 23) and administered while adsorbed to an adjuvant, usually aluminium phosphate or aluminium hydroxide. The primary course of diphtheria prophylaxis consists of three doses starting at 2 months of age and separated by an interval of at least 1 month. The immune status of adults may be determined by administration of Schick test toxin, which is essentially a diluted form of the vaccine. 

In vivo diagnostics such as tuberculins, mallein, histoplasmin, coccidioidin and brucellin, are used to demonstrate an immune response, and hence previous exposure, to specific pathogens as an aid to diagnosis. Others, such as the Schick test (diphtheria) toxin are used to detect the presence of protective immunity. Because of their limitations, the trend has been to phase out these preparations, and tuberculins (as purified protein derivative, PPD) are now by far the most important of this group. 

Schick test Test to determine immunity to diphtheria. 

Mycosis of the guinea pig (W. Jadassohn, Mach, Nardin, 1951), herpetic and vaccinal infection of the rabbit s cornea, tuberculin ophthalmoreaction of bovids, urticarial reaction in the Prausnitz-Kustner test, cutaneous erythema by UV rays (Franceschetti and colL, 1951), dermatitis to croton oil, Schick test in guinea pigs (Musso, 1956). 

Musso, E. Quelques nouveaux resultats negatifs observes au cours d experiences avec la cortisone et Thydrocortisone (dermite k Thuile de croton, Schick-test, dermite aux rayons ultra-violets, herpes simplex et vaccine de la cornee, poussee mitotique par unguentum cetylicum. Acta endocr. (Kbh.) 21, 77—85 (1956). 

In premature infants, chemical skin burns were reported after the use of isopropanol for conduction of electrocardiography (Schick and Milstein 1981) and preparation of the umbilical stump for arterial catheterization (Bonacci and Haddow 1970). The patch-test concentrations for both are as is or in 10% aqua. 

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