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After the active phase of treatment is completed, careful follow
up and after care is essential. Patients are kept under supervision
for at least 5 years, and regular attendance for medical examination
and X-ray is arranged. Here the work of the Health Visitors is
of great importance, especially in encouraging the more difficult
patient who fails to attend regularly.
One of the great problems is the management of the chronic
incurable cases of pulmonary tuberculosis. These are usually in
the older age groups and unsuitable for any active treatment.
Although such patients have active infectious disease, they may
remain comparatively well for years. Their expectation of life
has even been increased since P.A.S. became available. Education
of these patients in simple hygiene and the prevention of the spread
of infection, is extremely important. Home supervision of these
patients and their contacts forms a considerable part of the Health
Visitors' work.
There are 93 such chronic cases known to the Chest Physician
(65 men and 28 women) of whom 65 are sputum positive at present.
25 of the men and 2 women are working under suitable conditions
in sheltered industry.
B.C.G. Vaccine.—This vaccine became freely available during
the year and has now been given to more than 250 child contacts,
nurses, and other hospital staff. In cases without previously
acquired resistance to tuberculosis, a considerable degree of
immunity is conferred by this vaccine.
Housing.—Good housing conditions are essential for sufferers
from tuberculosis and their families. During the past six years
general housing conditions in the Borough have improved enormously.
Over 3,000 new houses and flats have been erected. A
generous proportion of these has been allocated to cases of tuberculosis.
Many families from more congested areas of London
have been re-housed on the new estates at Kidbrooke, and many
Greenwich families have been moved to the Springfield and Cherry
Orchard Estates of the Greenwich Borough Council. In spite of
these, there are unfortunately, still many cases needing re-housing.