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dates back to before that of the next case occurring in the household,
there is a strong suspicion that the original case was a source of the
infection to the other. Out of the 102 patients who apparently contracted
their infection while living in the district 22 gave a family history
of tuberculosis.
The occupations of some people expose them to infection to a greater
extent than are the rest of the population. Similarly those at some
trades or places of work have a higher incidence of infection not necessarily
associated with increased risk of exposure to infectious persons. There
were seven instances this year of this type of case.
Some illnesses or other states seem to pre-dispose to the onset of
tuberculosis to such an extent that it is possible that in some cases had
there not been these pre-disposing causes, the patient would in fact
not have suffered a clinical attack. There was only one such instance
this year.
All these conditions which might have been important factors in
leading to infection in some or in causing a break-down in others can be
found in only about one quarter of the notified cases. In all the rest, no
such cause could be found, and without any warning and for no known
reason an average of two people in the district succumb each week,
people who have not been especially exposed to infection, have not been
engaged in occupations of special risk, who are living in good homes and
who are not subjected to any special stress or poverty or ill feeding.
Although so much is known about a number of diseases, what organisms
are responsible for them and how they are spread, unfortunately so very
little is known of what makes any person succumb and while in many
cases the reason can be suspected, in very many more it is just not known.
Register
The tuberculosis register is a compilation of the names of those
persons in the district who are suffering from the disease or have recently
suffered from it. The names of those newly notified are added to it, and
entries are made of those persons who have moved into the district
suffering from tuberculosis. Names are deleted on the removal of
persons from the district or on death or recovery, an accepted standard
of recovery being a lapse of five years in the pulmonary cases and three
years in non-pulmonarv cases from the date the disease was arrested.