View report page

87
thirty-four children in her class, all but one were negative to the tuberculin
test so no further examinations on them were necessary. The one child
who reacted positively had previously been inoculated with B.C.G. Nine
other teachers in the school attended for x-ray examination ; all were
found to be clear.
In August, a girl living not in this district but attending a Grammar
school here, was found to be suffering from pulmonary tuberculosis.
She was fifteen years of age. This meant that most of her immediate
contacts had had the opportunity of being given B.C.G. inoculation
some two years before. On that occasion the preliminary tuberculin
testing would divide these contacts into those who reacted positively and
those who reacted negatively; these latter would then be given B.C.G.
and would become tuberculin positive. This means that the very fact that
this group of girls had been given B.C.G. blunted one of the weapons
which can be used to detect hitherto unrecognised cases of this infection.
This possibility was fully appreciated at the time the B.C.G. inoculation
scheme was introduced, and is in fact one of the reasons for not introducing
this arrangement in areas where the incidence of tuberculosis is
low. This is the first time this complication has been met in this district.
The procedure followed in this case was to discover which of this girl's
immediate contacts who had been tuberculin tested were tuberculin
positive, either naturally or as the rusult of B.C.G. inoculation. The
nine who were not known to be tuberculin positive were invited to the
chest clinic for examination. Satisfactory reports were received about
those who accepted the invitation to attend.
No investigations were carried out in the case of two other pupils
discovered to be suffering from pulmonary tuberculosis. The first was a
pupil not from this district who attended the Outward Bound Course
early in the year and who was found later to be suffering from pulmonary
tuberculosis. A boy of fifteen from a local school also attended this course.
As he had had been in close contact with the patient, he was examined
and found to be suffering from a primary lesion. As he was not infective
and as the source of his infection was known, there was no need to examine
his school contacts. The other case was a girl of fourteen from a local
school who in May was found to be suffering from pulmonary tuberculosis.
This child was one of those thirteen-year-old children who were
tuberculin tested prior to B.C.G. inoculation. As she reacted positively
she was referred to the chest clinic where the disease was recognised. The
usual procedure when a child or teacher is found to be suffering from
tuberculosis is for the immediate contacts to be tuberculin tested and the
positive reactors further examined. In this instance though these steps
had already been taken before the diagnosis of this child was made and
n° further investigations were carried out.
There was a third case, a girl of thirteen attending a private school,
he almost certainly had contracted her infection at home. As she was
considered not to be infective, there was no need to carry out investigations
amongst her contacts with a view to detecting the disease amongst
them.