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16
There are now less than l/10th of the proportion of tuberculosis
deaths in the 5-15 year school age group compared
with the year 1945. In infancy it is of interest that
Whooping Cough now accounts for almost three times as many
deaths as Tuberculosis.
Notification of Tuberculosis has only been in operation
since 1912 and with this notification, the expansion
of the work of the Chest Clinics, the tracing of contacts
of recent cases, and of recent years the Mass Miniature
Radiographical examinations there has been a great increase
in the detection of mild cases, formerly a considerable
proportion of whom would have overcome their own infection
and would probably not have been recognised as cases of
tuberculosis at all.
With the fall in tuberculosis rates and the likelihood
of its disappearance within a few years from our list of
major infectious diseases it is important that every
possible investigation that can be made regarding the
natural trends of the infection should be closely watched..
In this country we have, as a result of tuberculosis
testing and X- ray examinations obtained certain data which
has shown that the infection which has normally risen
from about 10% to 60% between the ages of 5 and 20 years
is now in the decline, since the Medical Research Council
survey showed that the 15 to 16 year olds who were positive
was 40% boys and 55% girls as compared with the Prophit
survey of 1948 of a 63% overall figure for the same group.
This reduction in infection among children as shown by
the Tuberculosis Test gives us the clue to the disappear
ance of tuberculosis and could certainly be used as a
check in years to come on a possible re-appearance of
tuberculosis at the beginning of an epidemiological wave.
Testing children by these tuberculosis reactions is a
simple matter and is quite easily carried out as part of
the normal school inspection. If, however, the use of
B.C.G. (which is a live avirulent Tubercle bacillus) is
made available to everyone in the country and is used on
small children as it is at present in Scandinavian countries
then this use of the Tuberculin reaction would of course
be valueless since every child given B.C.G. would automatically
become positive to Tuberculin test and it would
be impossible to assess the amount of infection that is
naturally abroad.
The recent survey carried out by the Medical Research