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73
Of the 8,454 who attended these public sessions, 3,021 were men and
5,433 women. Out of all those examined, 182 persons were referred to
the chest clinics for further investigation. Out of the 102 who attended,
19 were found to be suffering from active tuberculosis.
In recent years mass miniature radiography has detected no fewer
than eighteen per cent, of new cases. With the falling incidence less can
be expected from the examination of the general public and more will be
gained if surveys become more selective. More attention can now be
given to detailed examination of areas with above average incidence and
to social groups which have a relatively high infection rate.
Family contacts are urged to attend the chest clinic for examination
and many fresh cases are discovered by this means.
When a school child is recognised to be suffering from pulmonary
tuberculosis, the source of infection is first looked for amongst members
of his family or other close contacts. If there is no such suspected source,
then factors might point to a school infection. As the patient himself
might have been ill for some time during which he might have been
infective, it is sometimes desirable to examine his classmates to see if
he has possibly passed on infection to any of them. What applies to a
school child applies with still more force to the teacher at a school because
of the greater liability of his transmitting the infection. There were
several occasions this year when investigations at the school were felt
to be necessary.
The first was when a pupil of a private school who had recently
had an attack of measles was later recognised to be suffering from
pulmonary tuberculosis. On this occasion it was felt wise to examine
all the school; 71 pupils and six members of the staff were seen. Nine
of the pupils were found to be tuberculin positive. Of these four were
kept under observation for a time.
The next case was that of a teacher at a local school. Enquiries
showed that it was unlikely that he was in fact a risk during the short
period he was at the school in this district.
In September a girl who up to July had attended a local school
was found to be suffering from pulmonary tuberculosis. On the schools
re-opening after the summer holidays, the four girls in that class who were
still at school were examined, all with negative results. Most of the
others who live locally who had been in that class and who had left school
attended for examination; again all with negative results.
In November a boy at a private school and in December another at
a maintained school were discovered to be suffering from pulmonary
tuberculosis. Investigations were carried out when the schools reopened
in January, 1957.
An unusual case of a person at risk was a midwife who contracted
this infection. The mothers with whom she had been in contact and their
Wants all attended for examination, in every case with negative results.
Another means of discovering cases that might otherwise not have
been recognised for quite a long time is the examination of the contacts
of tuberculin positive reactors amongst school entrants, the theory being
at a child of that age who has been exposed to infection will have had
at exposure in his own home. 237 children were tested in this way