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66
When the disease is recognised in a pupil at a school, it may be
worth while examining the other pupils of the school, or of the class
and possibly the teaching staff with the object of perhaps detecting
amongst those contacts the source of infection, or possibly detecting
in those contacts some who have contracted the infection though they
are in the earliest symptomless stages. Although many such investigations
have been made in the district, no case has yet been discovered by this
means. Last year there was no occasion on which it was felt that there
was any point in carrying out the investigation in the school attended
by a child who was notified to be suffering from tuberculosis, because
in this year all such children were considered to have been infective by
a known source outside the school; and as they were not themselves in
an infective state, they had been of no risk to their fellow pupils.
A further trial of the tuberculin testing of school entrants at some of
the schools was continued. Although amongst the small numbers
tested the examination did result in recognition of the disease in one
pupil, it did not lead to the recognition of any cases amongst the home
contacts of the positive reactors. As a small child whose tuberculin
reaction shows he has been exposed to infection by the tubercle bacillus
has most probably been exposed to that infection in his own home, the
failure to discover infectious patients amongst the home contacts does
not necessarily indicate that this tuberculin testing of school entrants
for this purpose has no value. On the contrary it suggests that the tests
applied to those contacts who attend for examination are not sufficiently
delicate.
Of the active preventive measures that might be taken to raise the
resistance, that most commonly used is inoculation with B.C.G.
Although the Ministry of Health had previously given permission to local
authorities to arrange for older school children to be treated, most
authorities probably decided to wait on the findings of the Medical
Research Council's enquiry into the efficacy of the practice.