London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
London County Council 1937
[Report of the Medical Officer of Health for London County Council]
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A sufficient number of non-pulmonary cases has now been investigated to justify publication of a separate table, which is subjoined.
| Relationship | Clinical classification | 0-15 | 16-20 | 21-25 | 26-30 | 31-40 | Over 40 | No. | Percentage |
|---|---|---|---|---|---|---|---|---|---|
| Parent | Pulm. tub. class T.B. +, living | 21 | — | — | — | 23 | — | ||
| Pulm. tub. class T.B. —, living | 10 | — | 10 | _ | |||||
| Pulm. tub. (condition of sputum unknown), living | 2 | — | — | — | — | — | 2 | — | |
| Non-pulm. tub., living | _ | _ | _ | 6 | _ | ||||
| Non-pulm. tub., dead within last 5 years | — | — | — | — | — | — | |||
| Pulm. tub., dead within last 5 years Total | 13 | — | 2 | — | — | 16 | — | ||
| 51 | 3 | 1 | 58 | 59.2 | |||||
| Husband or wife | Pulm. tub. class T.B. +, living Total | — | — | — | — | 0 | — | ||
| — | — | — | — | 0 | 2.0 | ||||
| Child | Non-pulm. tub., living | — | — | — | _ | — | i | _ | |
| Pulm. tub., dead within last 5 years Total | — | — | — | 2 | — | ||||
| — | — | — | 3 | 30 | |||||
| Brother or | Pulm. tub. class T.B. +, living | 8 | — | _ | — | 10 | _ | ||
| sister | Pulm. tub. class T.B. —, living | 2 | 2 | — | — | — | — | ||
| Non-pulm. tub., living | — | — | — | — | 15 | _ | |||
| Pulm. tub., dead within last 5 years Total | 2 | 2 | — | — | 6 | — | |||
| 25 | — | 35 | 35.8 | ||||||
| Total | Pulm. tub. class T.B. +, living | 29 | 2 | 2 | — | 35 | 35.8 | ||
| relatives | Pulm. tub. class T.B. — , living | 12 | 2 | — | — | — | — | 14 | 14.3 |
| as above | Pulm. tub. (condition of sputum unknown) living Non-pulm. tub., living | 2 18 | 2 | — | — — | 2 22 | 20 22.4 | ||
| Non-pulm. tub., dead within last 5 vears | — | — | — | — | — | 1.0 | |||
| Pulm. tub., dead within last 5 years | 15 | 2 | 5 | — | 24 | 24.5 | |||
| Total | 77 | 7 | 8 | 3 | 98 | 1000 | |||
| Other contacts No known contact | 17 134 | 5 28 | 2 37 | 6 20 | 3 30 | 2 24 | 35 273 | — | |
| Total number investigated | 228 | 40 | 47 | 29 | 34 | 28 | 406 | ||
| Percentage showing important contacts | 33.8 | 17.5 | 17.9 | 10.3 | 2.9 | 7.1 | _ | 24.1 | |
| Percentage showing any contact | 41.2 | 30.0 | 21.3 | 31.0 | 11.8 | 14.3 | — | 32.8 | |
It will be seen that 406 non-pulmonary cases have now been investigated and
that approximately one-quarter show contact with a previously known case of
tuberculosis in the intimate family circle, while almost one-third show contact of
some sort thought worthy of record. The highest incidence of a previously known
case is seen to be among the children under 15 years, 338 per cent, showing important
contact. In 51 out of these 77 instances in which a child suffering from nonpulmonary
tuberculosis was noted as having been in contact with a previous tuberculous
case in the family, the original case was a parent. Moreover, all but 5 of these
51 cases of tuberculosis in parents were suffering from pulmonary tuberculosis.
This would seem to confirm bacteriological experience that a substantial proportion
of non-pulmonary lesions in childhood is due to infection with human tubercle
bacilli from pulmonary sources. Efforts to prevent non-pulmonary tuberculosis
of the bovine type, while very important, cannot be expected to influence the
infection due to human bacilli.