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44
added to the register of notified cases. There were also new observation
cases placed on the clinic register - but again approximating equal numbers
between men and women.
The number of cases occurring in children was again small - 6 only being
diagnosed in the year. This includes one observation case and two of nonrespiratory
disease. All cases had a contact history and none had had B.C.G.
vaccination.
Non-Respiratory Tuberculosis
No case of bovine infection was recorded - this form of tuberculosis has
been eradicated by the heat treatment of milk and the tuberculin testing of
cattle. The 8 new cases during the year could be traced to an initial primary
lung infection of which the non-respiratory disease was a secondary manifestation.
TABLE 2
Year
Total on
Register
New cases
diagnosed
Deaths
Recovered
1951
1,541
266
62
29
1952
1,512
152
38
19
1953
1,434
115
39
31
1954
1,395
159
20
27
1955
1,281
86
12
25
1956
1,242
80
21
9
1957
1,252
128
7
12
1958
1,214
118
7
32
1959
1,240
86
8
12
1960
1,239
89
12
26
1961
1,159
77
23
28
1962
1,144
60
18
12
Table 2 compares chest clinic figures over the past 12 years and demonstrates
the continued fall in incidence of pulmonary tuberculosis. The fall is
slow compared with ten years ago, the hidden infector pool of chronic sputum
positive carriers is still responsible for sporadic cases and is difficult to
detect and treat - particularly as a considerable percentage have tuberculosis
organisms resistant to drugs as a result of taking inadequate or frustrated
treatment using anti-tuberculosis chemotherapy.
This problem is to some extent met by the establishment of tuberculosis
hostels such as the one at Knight's Hill administered by the London County
Council. Here chronic infective ambulant cases are housed and cared for
under medical supervision and attend the chest clinic regularly. They are
encouraged to avoid presenting any casual infectious risk to other members of
the community and yet suffer no obvious stigma of segregation. Here too
are received cases previously uncooperative and reluctant to take treatment
who, responding to the hostel environment and persuasion, ultimately accep
chemotherapy and become non-infectious. During the year, of the 30 residents
6 only proved completely unresponsive to treatment and all of these
were carriers of organisms resistant to chemotherapy. The risk to others lS
greatly reduced when such men, often wanderers, are taken off the streets,
lodging houses and reception centres to be placed in special hostel accommodation.