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21
probably be ascribed to the activities of the Unit and the increased reference to the
Unit of patients by their General Practitioners. It has always been known that there
must be some people who, knowingly or unknowingly, are suffering from pulmonary
tuberculosis, possibly in an early stage, and who have not sought medical advice, and
are therefore undiagnosed. Such persons, not taking any personal precautions, can
be a dangerous source of infection to others who may be closely associated with
them, especially within the family. It is therefore highly probable that the additional
new cases reported during 1952 are part of this reservoir of unknown cases. The
fact that they came to light and do not represent a genuine increase is an excellent
advance from the public health point of view, since these patients now that they
are known can receive early treatment and supervision and can be advised as to how
best to safeguard both themselves and others with whom they must live.
At the same time, the warning against complacency still holds good. The
number of deaths due to pulmonary tuberculosis showed no decrease in 1952, and
although some of the new cases have undoubtedly come to light because of the
increased attention drawn to this condition through the presence of the Mass X'Ray
Unit in the Borough, it is impossible to say that there has not been a true increase
in the number of new cases, as compared with previous years. It was noted in the
Annual Report last year that in spite of some decrease in the notification rate for
new cases in the previous two years, nevertheless the number of cases of tuberculosis
on the Register has continued to increase. It is thought that this is due to the more
hopeful outlook for the individual tuberculous patient, and the increased expectation
of life of each case. This process has continued, and the total number of cases on
the Tuberculosis Register at the end of 1952 was 2,575 as against 2,404 in 1951, and
2,368 in 1950.
Of the total of 208 new cases of tuberculosis of the lungs in women, 130 were
between the ages of 15 and 35; probably the most difficult and disheartening agegroup
in which this illness can be contracted. Of the 310 new cases of lung tuberculosis
in men, 43 were aged 15 to 25, and 69 aged 25 to 35; again extremely serious
from the point of view of career, family responsibility and earning capacity.
Tuberculosis and Housing.
It is accepted by most authorities that bad housing conditions have an adverse
effect upon pulmonary tuberculosis. Certainly this would seem to be so in the case
of Islington. Islington is one of the most congested boroughs, confirmed by the
extracts given in Section C of this Report from the Registrar General's 1% Sampling
Analysis of the 1951 Census. The pulmonary tuberculosis death rate and notification
rate is also higher in Islington than the London averages. Many families with a
tuberculosis patient live in overcrowded conditions which do not permit of a
separate bedroom for the patient; or if a separate bedroom is provided, this causes
excessive congestion for other members of the family. Sufficient housing accommodation
is, therefore, even more important for such families than for families in
normal health, and considerable priority for re-housing is given both by the Islington
Borough Council and the London County Council as Housing Authorities where
there is a case of active pulmonary tuberculosis. In 1952 both these Authorities
rehoused 130 such families, but unfortunately, even with the priorities given, the
waiting list is such that many households with tuberculosis will have to continue to
live in unsatisfactory conditions for a considerable time to come before alternative
accommodation can be offered, and from the point of view of the community, as well
as other members of the family involved, this must be considered extremely
undesirable.