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Dysentery.—This disease shows great variations in prevalence from year to year and from place
to place. During the year 28 cases were notified as compared with 77 in 1951 and 6 in 1950. Nine of these
cases were originally notified as dysentery, three were notified as food poisoning and found on investigation
to be dysentery and the remaining 16 were found as a result of investigations by the Health Department.
There were 7 single cases while 2 cases arose in one household, 3 cases in one household, 4 cases in one
household and 6 cases in each of two households. The ages of these cases ranged from 1 to 81 years, fifteen
were over school age and six were under school age. No connection was traced between any of the households
affected and a point of interest was that all the cases occurred during the first half of the year.
The infection in all cases was of the Sonne type and the illness was mild in practically every case
The mildness of the illness is such that medical advice is not always sought and unless the disease is kept
constantly in mind cases are likely to be missed. In all cases of diarrhoea in children and on the least
suspicion in adults a specimen of faeces should be sent for bacteriological investigation. Only by such
vigilance will this disease be kept under some degree of control.
Tuberculosis.—During the year 148 notifications of pulmonary tuberculosis and 20 notifications
of non-pulmonarv tuberculosis were received. The trend of the Borough death rate from tuberculosis is
shown below:—

The decline in the death rate from tuberculosis in this country started about the middle of last
century and it is difficult to assess the many factors which may have played their part. A point of some
interest is that the age of maximum tuberculosis mortality in females remains under 35 years whereas it
has changed in males from 20-25 years in 1851-60 to 55-65 years today.
"Tuberculosis as a constitutional disease is a serious menace to public health in that it is infectious,
insidious in onset, usually runs a chronic course and exerts its maximum effect on those age groups that
are of the greatest value to the productive capacity of a nation."New drugs and methods of treatment
have recently altered the picture for victims of the disease but there is little or no evidence that we have
made appreciable progress in prevention. Here housing, after-care and health education can do much.
In 1906 Calmette and Guerin began to cultivate a particular strain of the tubercle bacillus and in
due course claimed that an injection of this strain would stimulate the body defence against the tubercle
bacillus without producing the disease itself in those inoculated. The strain is now known as Bacillus
Calmette-Guerin (B.C.G.) and since the war has been used extensively in many parts of the world. Very
conflicting evidence as to its value in preventing tuberculosis has been submitted and today the differences
of opinion as to its value and as to how it should be used are not reconciled. In 1950 the Ministry of Health
permitted the importation of the "vaccine" for use for "contacts," students and nurses.
In September, 1950, the Tuberculosis Research Unit of the Medical Research Council started an
investigation into the preventive qualities of the vaccine and in an attempt to decide whether or not its
general introduction into this country is justified. Those taking part in the trial are all volunteers from
pupils in their last year at Secondary Modern Schools and Heston and Isleworth is one of the participating
districts. During the last term at school each volunteer had a chest X-ray and after preliminary tuberculin
skin tests a proportion were inoculated with the vaccine. Over 50,000 children throughout the country
are now concerned in the trial, and they will be followed up for three years by annual tuberculin skin tests,
X-ray of the chest and home visits by Health Visitors. The response in the Borough was good and it is
hoped that the volunteers, who have now left school, will co-operate till the end of the trial. It is hoped
that this research will settle the question as to whether B.C.G. should be used for selected cases or should
be made available for all.
In July the Mass X-ray unit visited Heston Aerodrome and 733 staff attended for X-ray. A scheme
is in operation in Middlesex designed to encourage pupils, after leaving school, to submit themselves to regular
chest X-ray examination. Lists of the names and addresses of pupils leaving school are sent by the
Education Department to the mass X-ray unit and the scheme is explained in the following letter which
is sent by the Medical Officer in charge of the mass X-ray unit to the parents:—
" During their school days, your children have led fairly protected lives, as far as exposure to
Tuberculosis is concerned. This is because they have only come in contact with a limited number of
adults, and Tuberculosis is much more often found in adults than in children. As soon as school leavers
enter the community at large, whether as students, factory workers, or clerks, they mix with many more
adults, some of whom will probably be suffering from unsuspected Tuberculosis.
To protect your children during the first five years after they have left school, at a time when the\
are Most Vulnerable to Tuberculosis the following scheme has been worked out for school leavers of the
County of Middlesex:—
1. A register with the names and addresses of all school leavers will be kept by this Mass X-ray Unit.
2. Within a year of leaving school, all children will be notified by letter when the Mass X-ray Unit
is in their neighbourhood, and asked to attend for a chest X-ray.
3. This procedure will be repeated until the school leavers reach the age of 21. It is hoped that by
then they will realise the benefit of regular chest X-rays, and of their own accord make arrangements
to be X-rayed each year.
4. Results of the X-ray examinations will be sent to the parents.
I hope that all parents will co-operate in this vast preventive scheme, and ensure that their children
respond to our annual invitations."
Ophthalmia Neonatorum.—Two cases of this infection of the eyes of young babies were notified
during the year but neither case suffered any permanent damage to sight.
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