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102
again were not of an unusually high proportion of positive reactors, and
the x-ray examinations of the chest of those who reacted positively were
clear.
B.C.G. Inoculation. Another contribution made by the School
Health staff is by B.C.G. inoculation. The groups selected for treatment
are children of thirteen years of age. This entails a separate examination
as this is not an age group at which a routine medical examination is
carried out. As those who have already been exposed to infection do not
need the injection, the procedure is first to carry out a tuberculin test.
Those who react negatively are given an injection. Those reacting
positively are referred to the chest clinic for examination. It has proved
possible to carry out these tests on the relevant children at all schools in
the course of the year, the pupils at the Secondary Modern schools being
dealt with in the Spring term, those at the Grammar schools in the Summer
and those at the Independent schools in the Autumn term.

The corresponding figures for 1957 are shown in brackets. Of the
negative reactors, 2,511 were given B.C.G. Many were not inoculated at
the time of testing mainly because of recent poliomyelitis injections.
The surprisingly high proportion of acceptances to these arrangements
is presumably an indication of the public's dread of this disease. The
benefit to the public as a whole of such a procedure depends on a number
of factors, such as the incidence of the infection and the opportunities
for spread. The Ministry authorised these facilities being offered to this
group of children following the receipt of the report of the field investigation
carried out by the Medical Research Council and published in
1956. This trial showed that inoculations 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. It showed too that the protection conferred by
vaccine was evident soon after it had been given and was still substantial
after two to two and a half years. Later information suggested that the
protection was maintained up to four years. As children are being
inoculated when they are thirteen years old, this report was not offering
the hope of protection to those who had reached the age of eighteen. At
the time the report was written it could of course refer only to that period
of years, and it can be hoped that the beneficial effect would continue
for longer. The following is an analysis of the notifications relating to