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INFECTIOUS DISEASES
TUBERCULOSIS
Tuberculosis is still the most serious infectious disease in this country
but modern methods of therapy have made the outlook more favourable.
We should consider from time to time how best we may attack this
disease by the methods at our disposal. Prevention is best accomplished
by removing from the community the source of infection, in other
words by seeking out infected persons and giving them treatment to
render them non-infectious. Three methods of case finding are commonly
used. (1) Following up all contacts of the newly diagnosed cases.
By this means unsuspected infectious cases who are often in a reasonable
state of general health are discovered but unfortunately there is no
means of giving treatment or arranging isolation without consent of
the patient. (2) By mass X-ray, of the susceptible population. (3) By
"patch-testing" of children. This test, which is simple and painless is
applied to the skin and if positive it suggests that at some time the child
has been in contact with an infectious person and in the case of very
young children it is then often necessary to look no further than the
home for the source of infection.
One other method of prevention of tuberculosis consists of giving a
degree of immunity to children at the age of about 13 by using B.C.G.
(Bacillus Calmette Guerin) vaccine. This method has been widely used
in Scandinavian countries with success and the adoption of the method
is now under consideration in Hornsey.
In many countries it is now obligatory for immigrants to have a chest
X-ray before residence is approved, but the United Kingdom admits
immigrants without a chest X-ray although a perusal of the names of
notified cases suggests a fairly high incidence of pulmonary tuberculosis
among immigrants.
A mobile mass X-ray unit from the North-West Metropolitan Regional
Hospital Board again visited Hornsey in June, 1953.
4,677 persons were X-rayed of whom 96 were recalled for a large film,
18 persons were referred to the Chest Clinic for further advice.

The man referred to hospital was suffering from a cardiac lesion
which needed treatment.
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