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62
Deaths.
75 persons (35 male and 40 female) died from pulmonary
tuberculosis during the year and 14 (9 male and 5 female) from
non-pulmonary tuberculosis. The death rate per million population
was therefore 428 for the pulmonary disease compared with the
figure of 583 for England and Wales for the year 1936, the comparable
local figure for non-pulmonary tuberculosis being 80 and
the corresponding national figure 109.
Tubercular disease resulted in 89 deaths, accounting for 6.6 per
cent. of the total deaths in the district, the corresponding figure for
England and Wales being 9.
20 deaths, or 22 per cent. of those who died from tuberculosis,
occurred amongst patients who had not been notified in this district
as suffering from tuberculosis. In four of these cases the diagnosis
was made only as a result of post-mortem examination, and another
four of the deaths were due to meningitis. Almost all the remaining
deaths occurred in institutions outside the district. In the case of
two of the patients who died in this district there was an oldstanding
history of tuberculosis.
More than one-half of the patients died within one year of the
alleged onset of illness, only one-seventh surviving five years. Of
the fatal cases who had been notified here one-fourth were notified
only within one month of death, one-half within six months and
altogether only 60 per cent. within the twelve-month. Included in
these, of course, would be some who had transferred into the district
and would have been under supervision prior to having been
notified in this area. None of the fatal cases of non-pulmonary
tuberculosis survived two years from the onset of the illness.
42 of the deaths of the pulmonary cases and seven of the
non-pulmonary cases occurred in the district, mostly in the patients'
own homes ; while 33 of the pulmonary and seven of the nonpulmonary
occurred outside the district, mostly in institutions.
Preventive Measures.
Home visiting of tuberculous patients is now carried out by
the staff of the Middlesex County Council.
Bacteriological examination of sputa is carried out at the
laboratories of the Clinical Research Association, 195 samples
having been examined during the year.
No action was taken during the year under Section 62 of the
Public Health Act, 1925, for the compulsory removal to hospital
of any infectious tuberculous person.