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It is obvious from these figures that as the incidence of
tuberculosis among the population falls, so more and more
non-tuberculous cases are referred to us for investigation.
At the beginning of the year there were 1,802 cases on the
register and at the end of 1957 the figure was 1,686. One hundred
and ninety-two cases of respiratory disease were sputum negative
and 36 were sputum positive among the new cases notified in
this department. There were 15 new cases of non-respiratory
disease, making a total of new cases of 343 compared with 324
last year. Thirty-seven cases came in from other areas, but
85 cases on the register left Camberwell. Only 15 deaths
attributable directly to tuberculosis occurred during the year
compared with 24 in the previous year.
The shift in the emphasis of the treatment of tuberculosis
is clearly seen in the decline in the number of refills given for
collapse therapy. Only 420 refills were given compared with
1,214 in 1956, and since October, 1957, no new refill cases were
taken on: by December no refills at all were being given.
On the preventive side the number of B.C.G. vaccinations
was 695 and, in addition, 186 babies born in the maternity
department of this hospital were vaccinated.
Mantoux testing of schoolchildren continues and in this
way a number of new cases among schoolchildren and among
the parents and close contacts have been found. It is a great
pity that Mantoux testing is not carried out on all school
entrants and, furthermore, that those children who are found
to be Mantoux negative are not offered B.C.G. vaccination.
Under the present system a child has to wait until he is at least
10 before he can receive protection by B.C.G. vaccination.
During the year the Health Visitors have been kept fully
occupied and in all they made 4,306 successful home visits, many
of these visits involving a considerable amount of work, especially
those in which the Health Visitor was endeavouring to find the
contacts of Mantoux positive children.
We are indebted to the Divisional Medical Officer of the
London County Council and her staff for their willing assistance
and also to Dr. Chalke and his staff of the Borough Health
Offices. The District Nursing Organisations and the London
County Council Ambulance Service have, as always, been
extremely helpful.
KENNETH MARSH,
Consultant Physician.
Chest Department,
St. Giles' Hospital, S.E.5.