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18
as Area Medical Officer it would be ray duty to see that
the public are made aware that the B.C.G. vaccination can
be obtained for children aged 13 and 14 during the last
term of 1956, and it will rest with each individual parent
to decide whether or not they wish to avail themselves of
this method of protection against Tuberculosis.
The Borough Council of Ealing, however well aware
they may be of the background of Tuberculosis infection
in the area, and however they may wish to gain information
that would be of vital importance to future generations
if anti Tuberculosis campaigns again become necessary,
are not able to make decisions which lie within the competence
of many small areas of populations of 20,000 or
30,000 people. The indignity of such a position seems a
small reward for the enterprising and progressive health
policies previously given inception in the Borough of
Ealing, If there is to be no independence of thought based
upon such scientific evidence as is available about these
matters then our chances of making real progress will be
drastically limited.
Most countries in Europe have rushed into B.C.G
vaccination in an effort to stamp out Tuberculosis with
commendable enthusiasm but those more cautious and re
strained in their approach to this problem, such as a
number of districts in England similar in character to
Ealing can show results from other Tuberculosis work that
are comparable in every way with those districts using
B.C.G. indiscriminately.
In my own view the essential of Tuberculosis control
is the detection of the recently infected person as shown
by the Tuberculin test. Young children have limited con
tacts and by discovering those who are positive to Tuberculosis
among young children one is given a much better
clue to the finding of the causative case than in any
other way. Another factor that must be borne in mind is
the loss of this Tuberculin test value which would arise
from the use of B.C.G. since progressive Tuberculosis
development is greater during the first year or two after
conversion from the Tuberculosis negative to the Tuberculosis
positive than at any other period. This stage of
development can only be found therefore by having a clear
cut and reliable method of estimating the development of
tuberculosis by conversion to the test.
Whilst at the present time it is not proposed in view