London's Pulse: Medical Officer of Health reports 1848-1972

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East Ham 1946

[Report of the Medical Officer of Health for East Ham]

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56
In 1946, 22 cases of tuberculosis were discovered in an examination
of 441 home contacts of all ages, i.e. 5 per cent.
Experience of such contact examinations has shown that the
highest percentage of cases of tuberculosis is found in the 0-4 and 15-25
age groups. Taking the period of the last five years, the percentages
of contacts eventually notified were 13.6 and 6.3 in these two age
groups respectively, which must accordingly receive special attention.
In 1944 the percentages were at their highest, i.e. 21.4 and 9.3
The Medical Research Council (1942) in a discussion of contact
examinations recommends that young adults should be X-rayed at
three monthly intervals and continually under observation for at least
two years after contact is broken. The re-examination of contacts over
30 years of age may be dispensed with if necessary through pressure of
work, as being less likely to be productive of cases. Our own experience
supports this view, but if we are to carry out this work it is
imperative to hold at least one more routine session for dealing
satisfactorily with this problem in addition to other obviously
increasing demands on the staff of the Clinic.
In the 0-4 age group where the Mantoux test was positive in infants
under 2 years of age the sooner there was a break of contact with
infection the better was the outlook. The most disquieting feature,
from an analysis of deaths from tuberculosis in different age groups
during the war, has been the substantial increase among children and
this increase is still maintained. I referred to the increase in childhood
tuberculosis in my last report and stressed the dearth of accommodation
in existing institutions, which continues to be a problem. The
accompanying chart analyses the incidence of pulmonary tuberculosis
in these age groups for 1942-6.

EXAMINATION OF HOME CONTACTS OF TUBERCULOUS PERSONS.

Age Group 0—4.Age Group 15—25.
YearNumber ExaminedNotified T.B.% T.B.Number ExaminedNotified T.B.% T.B.
1942377195259.6
194328310.77334.1
194442921.45459.3
1945505103612.8
19464948.27045.7
Total2062813.6285186.3