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25
The number of deaths from Pulmonary Tuberculosis fell from
70 in 1949 to 48 in 1950. This corresponds with the great improvement
for the U.K. as a whole, where the rate fell from 40 to 32
per 100,000—a new record.
It will be seen from the graph that whereas the notification
rate of pulmonary tuberculosis in Ealing since 1935 has remained
fairly constant (apart from the rise during the war years) there has
been a steady decline in the mortality from 66 in 1934 to 25 in 1950.
An interesting feature shown by the tables is that in men the
risk appears to increase with age, whereas in women the older
age groups appear less susceptible.
This is apparently related to the mode of infection. The
cases in young women are due to primary infections in adult life ;
the cases in elderly men are due to re-infection or breakdown of
resistance in a previously healed disease process.
It is most important to prevent the young non-immune
person receiving a large dose of virulent tubercle bacilli. Young
women at special risk, such as nurses, are now tested as a routine
and all those who are negative reactors are immunised with B.C.G.
vaccine.
An experimental scheme was started by Dr. P. Dick to test
and immunise the children of school leaving age in certain parts
of the borough.
Although the death rate is falling, the number of notifications
remains high. This is in part due to more complete diagnosis
of the milder cases by means of the mass radiography system.
The long delay in the admission of patients to sanatoria
undoubtedly is a potent factor in the continued spread of the disease.
Pressure on beds also leads to too early discharge of patients from
hospital before the disease is fully healed.
The outlook recently for cases of tuberculosis has been
dramatically improved by the use of several new drugs (Streptomycin,
P.A.S. Theosemicarbazone) and the great advances in the
technique of chest surgery.
Tuberculous meningitis was once a uniformly fatal disease
but now a substantial number of affected children recover.
The main line of prevention remains the raising of resistance
by good housing, adequate ventilation and a mixed and nutritious
diet. A better standard of social hygiene, such as avoiding of
promiscuous coughing and sneezing, helps check the spread of
respiratory disease.