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86
In this last year, the infection caused a death rate of only 0.05 per
thousand population and was responsible for only 0.6 per cent of the
total deaths. The corresponding figures in 1934 were 0.57 and 7.1 and in
1946 0.42 and 4.9. The national figures for last year were 0.075 and
0.65, rates only half of these in 1954.
Preventive Measures. Early diagnosis is an important preventive
measure in that the recognition of a case in the earliest stage, possibly
before reaching the infectious stage, reduces the risk of infection to others.
This aspect of the work of the chest clinic by the examination of the
contacts of those found to be sufferers and their periodical re-examination
is of the greatest importance. At this clinic facilities are available for the
ready examination of those patients whose doctors are uneasy about them.
Many of the new patients notified each year are found in these two groups.
The mass x-ray unit plays its part in prevention in the same way by
leading to the recognition of the disease amongst some persons in whom it
would not otherwise have been discovered until later. This unit, which is
run by the hospital service, was here in July to September. In spite of its
appearing in more places than in former years and in spite of the greater
publicity given to its being here, the number of persons who visited was
some 800 fewer. 3,117 men and 4,943 women attended the public
sessions, 4,533 and 2,980 the industrial groups. Of these 15,563 people,
eighty-nine were referred for further investigation. The unit was not
open on Saturday mornings. The Public Health Committee, feeling that
if the unit were placed in a shopping centre and was open on Saturday
mornings many would attend for examination, made representations to
the Hospital Board. The suggestion was agreed to, and this arrangement
will be tried out at the next visit of the unit.
The school medical and nursing staff continued to play their part in
the control of this infection :
1. Tuberculin testing of the school entrants with the object of
finding the home source of infection in a positive reactor was continued
during the year. Of 253 children on whom the jelly test was used, ten
were positive. Two of these had had B.C.G. inoculation ; the x-ray
examination of the chests of the other eight were clear. 621 were tested
by the Heaf gun. Of the four who reacted positively, two had had B.C.G ;
X-ray examination of the chests of the others showed them to be clear.
2. Whenever a pupil or adult worker at a school is found to be
suffering from pulmonary tuberculosis, the question of carrying out an
investigation in the school is considered. When it is felt desirable that
anything should be done, the usual procedure these days is for the
immediate contacts to be tuberculin tested and x-ray examination of the
chest of the positive reactors carried out. It is only exceptionally that
more extensive enquiries are felt to be necessary. Investigations on these
lines were made on two occasions. In January, a teacher at a local school
was recognised to be suffering from pulmonary tuberculosis. The usual
routine investigations of immediate contacts were carried out. of the