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44
Table 2 compares Chest Clinic Figures over the past 11 years during which
time chemo-therapy has been available, and with a rise again this year in the
death rate illustrates the temporary effect of this treatment in chronic cases
where with the delay in fatal result there is the co-incident development of
drug resistant organisms. These cases when positive probably constitute the
infector pool during life and account for the present 5% incidence of drug resistant
infection occurring among new cases diagnosed.
The use of long term chemotherapy on cases at home and whilst at work
however considerably reduces the number of infector cases in the population and
may well be responsible for the fall in new cases this year, the lowest on record.
This applies also to the total number of cases on the Clinic Registers but this
still represents practically 1% of the community needing Chest Clinic supervision
and advice.
Treatment
New cases are in the very great majority diagnosed by chest X-ray
examination at a Chest Clinic, hospital or Mass Radiography Unit and a high
percentage are in the earlist stage of the disease susceptible to modern chemotherapy.
Most new cases needing active treatment are first admitted to a chest
hospital for initiation of chemotherapy which is subsequently continued as an
out-patient under Chest Clinic supervision. There were 29 such admissions
during the year. Out-patient chemotherapy is usually maintained on a long term
basis the course lasting 2 years and there were 219 such cases under treatment
during 1961.
The need for re-admission to hospital occurred only in cases suffering from
old standing chronic disease and none occurred in any case diagnosed during the
previous 2 years.
The Chest Clinic was well attended and there were 3,709 patient attendances.
The London County Council Tuberculosis Health Visitors paid 3,100 visits to
patients homes and during the year 88 patients received extra milk, butter and
eggs provided by the Council.