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79
Residential
open-air
schools
Certain children with a history of early or incipient or healed tuberculous infection
were admitted to residential open-air schools for delicate children. No child
with known "open" or infectious tuberculosis was, however, taken. The schools
maintained by the Council in use at the beginning of 1950 were:—
Burrow Hill Colony School, Frimley ;
George Rainey School, St. Leonards-on-Sea;
Wanstead House, Cliftonville;
Swanley Residential School, White Oak Hospital, Swanley;
Kathleen Schlesinger School, near Henley;
Bowden House School, near Seaford; and
Wainwright Residential School, Broadstairs.
The total number of places in them is 441.
In addition some were accommodated in private residential open-air schools.
At the end of the year 38 children with a history of primary tuberculosis were
in residential open-air schools. This is a service which provides suitable convalescence
in good surroundings and with educational facilities for children who need "building
up "for several months to tide them over a "primary" infection.
B.C.G.
vaccination
By September, arrangements were completed to provide, through chest clinics
facilities for B.C.G. vaccination of susceptible (tuberculin negative) contacts of knowr
cases and the newborn children of tuberculous mothers.
The procedure involves getting parental consent after full explanation of the
purpose; ordering a special supply of the fresh living vaccine; making skin tests
on the children concerned both before, and after, vaccination, the former to ensure
that the child is not already infected with the disease and the latter to test whether
or not the vaccination has been effective.
All this, added to the work of already very busy and often understaffed chest
clinics, inevitably delayed full application of this preventive measure, but by the
end of the year 271 contacts were known to have been vaccinated in London under
the Council's scheme.
Arrangements were also completed with other county medical officers of health
for suitable children boarded-out under the Council's tuberculosis contact scheme,
to be vaccinated with B.C.G. by the chest physician of the clinic in the district
where they are staying. Children boarded-out solely for vaccination during segregation
are also included in this arrangement. The very willing co-operation of the medical
officers of health and chest physicians in many places as far apart as Northumberland
and Cornwall, has been invaluable. The number of children known to have been
vaccinated under this arrangement by the end of the year was 43.
It is likely to take another year before B.C.G. vaccination of London contacts
gathers full momentum and takes an established place in our tuberculosis control
measures.
Tuberculin
survey
The survey, undertaken in two metropolitan boroughs by a special team of
the staff of the Medical Research Council and referred to in my last annual report,
was completed in March. It revealed that allergy (i.e., acquired special sensitivity
to the toxins of the Tubercle Bacillus due to previous contact with infection, but
not necessarily indicating actual disease) was present to a greater extent among
Southwark than among Fulham children. The percentage of positive tuberculin
reactors among those tested was 8.7 for Fulham 5 year olds (10.7 in Southwark)
rising to 16.4 for 8 year olds (23.3 in Southwark), to 25.6 for 11 year olds (32.2 in
Southwark) and to 32*1 for children aged 15 (44'7 in Southwark).
These findings suggest that there is somewhat greater exposure to infection
among children in Southwark than among those in Fulham and point to the desirability
of arranging more widespread periodic tuberculin surveys among children (separately