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67
some other district shall forthwith notify the Medical Officer of
Health of that district of the case.
During the year 152 cases (81 male and 71 female) were notified
as suffering from pulmonary tuberculosis. In addition 28 cases
(11 male and 17 female) were brought to notice other than by formal
notification. Most of this latter group will be of persons who had
recently removed into the district having previously suffered from
the disease and having been notified in some other district. These
180 cases added to the register of one year represents a rate of 1.25
per thousand population, a figure to be compared with a rate of
1.20 per thousand for the country as a whole. These figures,
however, are not strictly comparable because while the national
figure represents the number of new cases brought to notice during
the year, the local figures represent those fresh cases discovered
and notified in the existing population, plus roughly the total
number of tuberculous patients in the transferred population, these
having been notified not in any one year but over a number of
years. The average notification rate is one per thousand population,
whereas the register of notifications will contain eight per
thousand. Where a volume of population is transferred to any
district, the names will be added to the register of that district
not in the proportion of one per thousand transferred population
but at the rate of eight. Where the transferred population is small
as compared with that of the parent district, this factor is relatively
unimportant, but it is obviously significant if the volume transferred
in one year represents up to 10 per cent. of the original
population.
As far as information is available the notifications have been
divided into those amongst persons who contracted the disease
here and those who transferred here while suffering from it. With
regard to the latter point consideration has been given not only
to the time of notification in relation to the time of taking up
residence locally but rather the time of onset of the disease.
Furthermore, tuberculosis in most is a chronic disease, which,
although in some it appears as a bolt from the blue or as a sequel
to some acute disease, most commonly pursues a smouldering
course until some sign or symptom leads to its detection. For this
reason an arbitrary period of six months has been selected as representing
the average of that time between the onset of infection and
the diagnosis of the disease. Patients whose onsets were within
six months of their taking up residence here are assumed to have
transferred here suffering from the disease, whereas if the onset is
over six months from the date of transfer the disease is assumed to
have been contracted locally. As it happens there were very few
patients notified in which the period was round about the six
months, though a large number whose period of residence is a much
shorter period.
Of 84 males, the disease had already been notified in 26 before