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notified for the first time, is in respect of a patient whose tuberculosis was
not contracted in that area. Apart from the primary notifications are the
other notifications of persons removing to another district. This sort of
thing is only likely to happen in the case of a disease which can run into a
chronic and long-continued phase. When a person suffering from
tuberculosis moves to a new district he usually comes under the care of a
new doctor and that doctor is required to notify the case to the Medical
Officer of Health of the new district. Such notifications though relate to
persons already notified to the Medical Officer of Health of some other
district in the country, and these are not counted as primary notifications.
On the other hand, in some persons who are notified and particularly
when this occurs very soon after their removal into a district, it is apparent
from the history that they must in fact have been developing the disease
before they moved, even though they had not been recognised at that
time to be suffering from it and the patient had not been notified. Although
in such cases the disease must have been present before removal, because
the case had not been notified in the district from which the patient came,
the notification to the Medical Officer of Health of the new district of the
patient counts as a primary notification. Not all primary notifications
then are of patients whose breakdown in resistance occurred while they
were living in the district which accepts the primary notification.
This district is taking part in the general improvement seen in the
country as a whole. The number of primary notifications in 1958 was
only 118, compared with figures of 141, 160 and 183 for the years 1957,
1956 and 1955. The combined figures of those who were notified here for
the first time during the year and those who came into the district during
the year already suffering from tuberculosis was 199. The corresponding
figure in 1957 was 214, in 1956 264 and in 1955 287.