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27
(i) Tuberculosis.
The work being undertaken by the Medical Research Council
into the question of the value of the Anti-Tuberculosis Vaccine
B.C.G. was continued, and the unit revisited the area in order to
carry out Skin Tests and X-ray examinations of those children,
now adolescents, who partook of the scheme whilst at school, but
who subsequently had left school. A large percentage returned for
the examinations, and we are grateful to them for this co-operation
and for their continuing interest, also to the Health Visitors for
stimulating their attendance.
In the early part of the year two cases of Pulmonary Tuberculosis
were reported to me in one classroom of an infants' school.
The particular classroom was in hutted premises away from the
main building and accommodated some 115-120 children. A full
investigation was carried out with the co-operation of the Chest
Physician, the Headmistress, the Staff, and the parents.
With the consent of the parents, ninety-one children were
Mantoux tested and only two were found to be positive, indicating
that they had received primary infection. As I pointed out to the
Committee this primary infection is contracted by nine out of ten
of the population before reaching the age of 20 years, and in the
majority of instances is not accompanied by signs and symptoms of
Tuberculosis. In fact it creates an "acquired resistance" which
enhances any "native resistance" and increases the powers of the
tissues to overcome the harmful effects of subsequent infection. It
is only when "native resistance" is low, or the initial dose of bacilli
is large, that noticeable constitutional changes occur.
The two positive cases mentioned above were further examined
at the Chest Clinic, when it was shown that they had no evidence
of Tuberculosis.
Furthermore, the adult staff of the portion of the school in
question were examined and found to he free from infection. Likewise,
the home contacts of the two children who suffered from
Tuberculosis, and who initiated the investigation, were examined
and found to be free.
To sum up, there was no evidence that the disease was contracted
at the school or at home.
(j) Whooping Cough.
Altogether, 924 cases were notified. For the most part these
occurred in June, July and August. No deaths occurred from this.
As from the beginning of April, immunisation against this condition
was offered to the parents of infants. The preparation used
is Plain Suspension Vaccine, and three injections, subcutaneously,
of 1 c.c. are given at four-weekly intervals. A Whooping Cough is
most likely to attack the young infant, the treatment should for
preference commence at about the age of two months. As the
Medical Research Council have not yet completed their investigations
as to the best antigen to be used for combined DiphtheriaWhooping
Cough Immunisation, for the time being a separate series