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97
5 of the notifications were from General Hospitals; 10 of the notifications
were from Poor Law Hospitals and obtained treatment from
the Institution notifying.
The examination of contacts of the T.B.+ case, i.e., the patient
with germs in the sputum is the most important from the point of
detecting early disease in others who may be infected by the patient.
The table above shows that of 25 T.B.+ cases there were 78 contacts,
of whom 36 were examined at Dispensary, i.e., 46 per cent. Of the
child contacts, all cases, 53 were school contacts, of whom 23 were
not examined at Dispensary, and the school medical officer was informed
on card M.O. 333, so that they could be examined at school.
Therefore, of 122 total contacts, 47 were examined at Dispensary
and 23 at school; this equals a percentage of nearly 60 examined as a
result of notification.
Of all the other contacts, examination was definitely refused in the
case of 18. 15 promised to attend their own doctor.
It is difficult to get elderly persons to attend for examination, and to
realize that their "chronic bronchitis," say, is possibly the source of
infection to the children.
Last year, the great importance of the prevention of infection of
infants was referred to. Through the kindness of the Borough Council
I had the opportunity of visiting Norway during the year on a Tuberculosis
Study tour. In my report to the Public Health Committee I
related how, in the City of Oslo this problem is being dealt with ; a
special infants' home being established to receive, immediately after
birth, the infant from a tubercle infected home. In the three-and-a-half
years since its establishment, only one child admitted had died of
tuberculosis. The nearest approach we have to this is the London
County Council scheme for the boarding-out of children when the home
accommodation is insufficient, and a case of tuberculosis with germs
in the sputum is being treated there under conditions likely to cause
infection. During the year 11 children were recommended and accepted
and 8 were got away under arrangements made by the Invalid Children's
Aid Association. One of the other three proved unsuitable, and the
parents of the other two finally refused to allow the children to go.
In France an attempt is now being made to give immunity by
administering to the infant in the first few days after birth a variety of
tubercle bacillus which does not produce disease itself, but which renders