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71
was one. When the school re-assembled, it was found that many of the
pupils and many of the staff had attended for examination and more did
so about the beginning of the term. Ultimately, every member of the
staff was examined and all but 73 of the pupils, all with negative results.
At any time, such an enquiry can be carried out only as the result of
much work. In the particular circumstances obtaining at this time, it
was possible to arrange for the examination of such a high proportion of
those at the school only by the very generous help given by the headmistress
of the school and by those at the Chest Clinic.
Early in the Autumn term, it was learned that two pupils, a boy of
13 and a girl of 12 at one of the secondary modern schools had been diagnosed
as suffering from pulmonary tuberculosis. Because of the possibility
that both had been infected by a spreader at the school, arrangements
were made for Mantoux testing all the pupils with the intention of
carrying out a further examination of those found to react. 1,058 pupils
and 32 members of the staff were examined, but no cases were found.
In some districts, children detected to be suffering from tuberculosis
have been thought to have contracted infection at the school, more
especially when it has been discovered that a pupil of the school has been
suffering from open tuberculosis. The findings of the work done in the
schools in this district in this last year do not suggest that the risk of
spread from a pupil to his fellows is very great. That no cases at all
were found amongst the contacts of a pupil at school does raise the question
of whether the work involved in examining all the contacts is necessary.
On the other hand, had even one case been found where it was
suspected that the infection had been contracted at school and which
perhaps would not have been detected for some time unless these examinations
had been undertaken, there would be no question but that the finding
of that single case would have been ample reward for the expenditure of
much work. Until more is known of the magnitude of the risk, it would
seem better to continue to carry out such investigations even though the
findings continue to be negative.
Whatever might be found to be the size of the risk of spread from a
pupil to his fellows, it is felt that that from an infective teacher must be
very much greater. When therefore it was learned that a female teacher
at one of the secondary grammar schools was an open case of pulmonary
tuberculosis, arrangements were made to Mantoux test all the girl pupils
at the school. 300 pupils were examined but no further cases were
discovered.