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74
during the year, but in neither of the two positive reactors was an infective
home contact discovered. Some doubt whether these tests with their
subsequent follow up of the positive reactors is worth while. On the
other hand as the test shows that the child has been exposed to infection
and as the most likely place for him to have been exposed is his own home,
it is perhaps a matter for the chest physicians to burnish up their techniques
to enable them to discover the infectious persons that they are perhaps
at present missing.
Inoculation Against Tuberculosis. Although B.C.G. the vaccine
prepared from a tubercle bacillus rendered avirulent by repeated subculture
has been in use for some 30 years, it is only since the end
of the war that it has been used to any great extent. In some countries
it has been extensively used with apparently very gratifying results.
Nevertheless it was not until the trial carried out by the Medical Research
Council which started in 1950 and which was reported on earlier this year
that there was any scientific evidence of its efficacy. The findings of this
enquiry which was carried out on groups of school leavers in various parts
of the county were that the injection of vaccine into tuberculinnegative
children resulted in a marked reduction in the incidence of
tuberculosis amongst the vaccinated children as compared with what they
might have been expected to have had if they had not been vaccinated.
(" The annual incidence of tuberculosis in the tuberculin-negative unvaccinated
group was 1-94 per thousand; in the B.C.G. vaccinated group
it was only 0-37 per thousand.") The trial also showed that the protection
conferred by vaccine was evident soon after it had been given and was
still substantial between two and two and a half years. " Supplementary
incomplete information up to four years suggests that this is maintained
for this period."
In 1949 the Ministry of Health approved of local health authorities
arranging for B.C.G. vaccination to be given to persons known to be in
contact with tuberculous infection. In 1953 they approved of these
arrangements being extended so that authorities could offer B.C.G.
vaccination to older school children.
The County Council at its meeting in April 1954 approved of arrangements
being made to enable school children between their thirteenth
and fourteenth birthdays being offered protection against tuberculosis
by means of B.C.G. vaccination.
In three areas of the county advantage was taken of this approval to
inoculate school children of the appropriate ages. In the other parts o
the county nothing was done pending the findings of the Medical
Research Council enquiry into the efficacy of the practice.
The County Council at its meeting on the 25th July agreed that the
scheme should be extended so that all children in the county between
their thirteenth and fourteenth birthdays might have the opportunity
of being included in these arrangements. ,
At their meeting in November the local Area Committee agree
to these arrangements being made in this district. In the last weeks
of the year general medical practitioners and the head teachers of tee
schools attended by children of the appropriate ages were told of wna
was intended with a view to a start being made early in the new year