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conduct has become a source of serious annoyance to other hostel residents or to the
staff, or if he persistently and unreasonably refuses to pay the charges assessed.
These hostels provide the residents with the comfort and security of a home, with
regular good meals, laundry and sympathetic companionship and constant medical
care. The community derives advantage from segregating, as far as practicable, these
infective tuberculous patients from the dangers of close and frequent contact with
susceptible individuals.
Photographs of the accommodation at the Hurlingham Lodge hostel, Fulham, are
reproduced following page 34.
Services for children
Open-air
schools
For the convalescent tuberculous child of school age not yet fit enough to return to
normal school life, the Council provides day and residential open-air schools where
educational activities are continued at a gentle pace in good surroundings with special
emphasis on rest periods, medical supervision and nutritious dietary. Most children
stay at the residential type of school for about a year.
T uberculosis
contact
schcmc
The occurrence of tuberculosis in a household where there are children brings the
special problem of protecting them from the risk of infection and where the mother
is the patient, of their care during her treatment at home or in hospital. When satisfactory
private arrangements cannot be made to meet the conditions, use of the Council's day
nursery, child minder or home help services is first considered. Where these alternatives
do not cover the needs of the case the Council arranges, through the agency of the
Invalid Children's Aid Association, for such children to be boarded-out in approved
private nurseries or foster homes situated usually outside London. While boarded-out
the children remain under the surveillance of the local chest clinic physician.
Boarding-out is also arranged under this scheme when it is thought advisable to
segregate children from known cases of tuberculosis during the process of B.C.G.
vaccination.
B.C.G.
vaccination
(i) B.C.G. vaccination has been provided under the Council's auspices since 1950
at chest clinics in London for the susceptible (tuberculin negative) contacts of known
tuberculous patients when parental consent is given. Only about a third of the contacts
seen at chest clinics at the time of diagnosis of the 'index' cases are still tuberculin
negative. Some 4,000 contact children were vaccinated at the chest clinics in London
under the Council's scheme during the year.
During the five years in which this service has been available only very rarely has
a vaccinated child remaining in contact with the tuberculous relative developed disease—
far, far less often than in the unprotected tuberculin positive contacts.
(ii) Since 1953 diabetic children residing at the Council's special residential school
for such handicapped scholars have been tuberculin tested and, with parents' consent
and if negative reactors, have been vaccinated with B.C.G. as special protection for this
vulnerable group.
(iii) In June, 1954, the Council instituted routine B.C.G. vaccination for all tuberculin
negative 13-year-old children attending London schools whose parents had given
written consent. By the autumn of 1955 this protective measure had been offered for
children in all these schools. 76 per cent. of the parents took advantage of the offer and,
out of 22,569 children tuberculin tested, 19,301 negative reactors had been vaccinated
with B.C.G.
This work is carried out in 415 schools by the full-time medical officers of the two
B.C.G 'units', each school being visited twice in a week. On the first occasion the
doctor gives the tuberculin test and at the second visit three days later notes and records
the result and vaccinates the negative reactors, who are given a certificate of vaccination.
The parents of children showing a 'positive' reaction are given a leaflet explaining its
significance, and chest X-ray examination is subsequently arranged for these children
when the parents consent. Children in out-County residential schools, approved schools
and remand homes are also included in the scheme.
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