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7
infection. It is surely an indication that infection still lurks and its
control requires constant vigilance.
Once again I am glad to report no maternal deaths.
Infectious diseases continue to decline significantly. Total
notifications were only 569, a reduction on last year of 673, due in
large proportion to the low incidence of Measles, but there were also
considerable reductions in Scarlet Fever and Sonne Dysentery.
Once again the Borough was comparatively free from Poliomyelitis,
having only 3 paralytic and 2 non-paralytic cases. Unfortunately,
there was one death.
A case of Nasal Diphtheria of a mild type was our first for some
years.
The hard core of Pulmonary Tuberculosis remains, for while
deaths declined slightly, notifications were above last year's figure
and the number of patients on the Pulmonary Tuberculosis Register
increased by 67 to 972. It would appear that a case can be made out
for a more intensive campaign of BCG vaccination among vulnerable
classes. The efficacy of this vaccine is I think generally accepted
and Tuberculosis may have to be tackled now using BCG with the
same determination and resolution as Diphtheria was attacked
between the wars. Already Mass Miniature Radiography throughout
the country has yielded valuable results, but perhaps the use
of this diagnostic facility as a general screening method for casefinding
in the community at large should be reviewed in the light
of experience.
Some physicians and hygienists criticise Mass Miniature
Radiography on economic and indeed on epidemiological grounds
and the fact remains that there are many people who, suspecting
that they may suffer from Pulmonary Tuberculosis, prefer to remain
in ignorance of the fact. On the other hand, many who are not
open to any apparent risk and who remain continually in good
health, are screened over and over again and are pronounced clear
with monotonous regularity. It is thus argued that too often
Mass Miniature Radiography is reaching and screening the wrong
people. Short of compulsion, which is always unacceptable, it is
difficult to see how this objection can be overcome and in any case
it is not a valid criticism of Mass Miniature Radiography as a
principle ; but more and more I am tending to the view that Mass
Miniature Radiography might with advantage be re-deployed
and be reserved for the investigation of specific community groups,
for ' black spots ' where incidence is high and risk of infection greater
or, for workers engaged on certain manufacturing processes known