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15
The majority of these early exposures to infection regain health
without active treatment leaving the person thus exposed with a
certain amount of resistance and immunity to the disease. By the
age of 20 years countless contacts have been made and it would be
impossible to trace the source of infection. However, in the case of
very young children showing a positive reaction their contacts have
been few and it is necessary to examine only close family contacts.
In this way many cases of hitherto unsuspected early tuberculosis
cases have been detected.
Routine tuberculin jelly testing has been carried out on children
from the age of 2 years onwards at the Child Welfare Clinics for the
last few years.
Every child in the Borough receives a birthday greeting card
and is invited to attend the local Clinic for medical check up. At
this examination the test is performed with the consent of the parent
after its purpose has been explained.
A positive reaction is not a cause for alarm. As has already
been explained it indicates that the child has had or is having his
primary infection at an early age and such children are kept under
closer observation, and other members of the household are X-rayed
for a possibly unsuspected source of infection in the home.
During 1954, 1,811 children in Ealing were tested and 40 were
positive (2.2%). 27 of the positive reactors were seen and at the
Chest Clinic were found to have negative X-rays and were discharged
Nine others were kept under observation at the Clinic. Information
is lacking on the remaining four as they had left the district.
Tuberculin testing is also carried out on children in the Ealing
Day Nurseries on admission and subsequently at 6 monthly
intervals. 93 children were tested on admission and were found to
be negative and 130 children were re-tested of which 2 were found
to be positive and were referred to the Chest Clinic.
Whooping Cough.
The incidence of this disease fluctuates from year to year.
There were 116 notifications during 1954 as against 491 in 1953.
There are periodic cycles of occurrences, usually in alternate
years and this may be because the children who escape infection
probably develop a temporary latent immunity These number
twice as many as are attacked. This immunity is, however, short
lived, probably of one year's duration and at the end of this time
the immunity has waned The accumulation of susceptibles thus
produced leads to an epidemic
The incubation period of whooping cough is usually seven
days with rare cases observed up to 21 days The initial catarrhal
stage is very infective.