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19
The present outlook regarding tuberculosis is more hopeful
than has ever been the case before, with a steeply declining death
rate throughout the country.
This is due to many factors, one of the basic ones being full
employment for many years and a scientific nutrition policy with
regard to rationing, food subsidies and provision of vitamin supplements
for expectant mothers and children. The provision of works
canteens and school canteens has also led to a general improvement
in nutritional standards.
Housing policy in giving a degree of priority for rehousing
to members of tuberculous families where there is overcrowding
has helped to reduce the risk of spread.
The general improved prognosis is known to the public so that
there is a much greater willingness to undergo X-ray examinations
and sanatorium treatment.
It has been suggested that the decline is in part because
we are now at the end of a long drawn out pandemic of Tuberculosis
but that is not the whole story as shown by the great increase
in those continental countries whose welfare services were destroyed
during the recent war.
The mass radiography unit visits the Borough regularly,
and a recent innovation has been the policy of asking for an X-ray
of the chest of all persons whose work brings them into contact
with children, e.g., teachers, health visitors, nursery nurses, and
where possible, routine re-examination every year.
Dr. Dick's scheme for detection of school children who are
Mantoux negative (i.e., not sensitised or immunised against Tuberculosis)
is being continued ; and these children are offered vaccination
with Bacille Calmette—Guerin (B.C.G.) and are then followed up
with yearly X-ray examinations.
A survey is also being carried out of the children of 2—3
years of age in the Borough using the Tuberculin Jelly test to detect
early infection.
The follow up of contacts of the disease is normally carried
out by the staff of the chest clinic, but in a number of cases the
public health department has carried out investigations of school
contacts where no primary source of infection was obvious in the
home.
It is a remarkable fact that in the years since the war we
have seen the emergence of 5 new groups of drugs which are of some
value in the treatment of this disease (Sulphones, Thio SemiCarbasone—P.A.S.—Streptomycin
and Iso-nicotinic acid) and