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2. ISOLATION
During the year waiting lists for admission to local sanatoria
vanished for the first time, and we are now in the fortunate position
of being able to secure the admission of any patient to hospital within
a few days when this is necessary.
There will now presumably be little demand for the loan of
garden shelters for home isolation, since when the patient's condition
demands it and where a separate bedroom is not available at home
an immediate transfer to hospital will be made.
Where patients are, for one reason or another, being nursed at
home the hygienic disposal of sputum is of great importance in the
prevention of spread of infection. After discussion with Dr. Paterson
I did make arrangements so that, on his recommendation, patients
could obtain plastic sputum containers and supplies of a special
disinfectant for use with these flasks.
Later in the year the County Council's arrangements for the care
and after-care of the tuberculous were modified so as to permit of
these being provided routinely through Health Area sources.
3. SURVEILLANCE
The tracing and regular examination of family cor acts is one of
the main jobs of the chest clinic. It is a task which is carried out
extremely well in Barking, although of course from time to time we
fail to persuade relatives (particularly Granny or Grandad) to attend.
B.C.G. vaccination is offered to all contacts where necessary.
4. TRACING SOURCES OF INFECTION
(a) Skin Tests
The memorandum drew attention to the value of these skin test
particularly amongst the school population—both to detect childhood
infection and, indirectly through them, previously unsuspected adult
cases of tuberculosis.
I believe that a T.B. skin test should form anintegral part of
every routine school medical examination and 1 had hoped to arrange
this long ago. In view of the apparent unreliability of the jell)
test in older children, referred to in my last year's r port, I thought
it wise to await our experience with the "Heaf" test however.
reported later will now enable me to submit suggestions for the
incorporation of these tests with periodic medical examinations.
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