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103
Rehabilitation of Tuberculous Patients.
Financial responsibility was accepted for the rehabilitation of
one case at the British Legion village from 1st February to 25th
July when responsibility was suspended owing to his re-admission
to hospital.
Prevention.
B.C.G. vaccination and Contact examinations are referred to
above. In addition there were Chest X-ray examinations for all
persons in contact with groups of children, especially teachers, Mass
X-ray examinations, special examinations by means of the Odelca
apparatus at the Chest Clinic for patients referred by Family
Doctors and the rehousing of infectious cases.
The following information in regard to the infectivity of
tuberculosis is taken, with his permission, from an article by
Professor F. R. G. Heaf, M.D., F.R C.P., David Davies Professor
of Tuberculosis, University of Wales, and merits wide publicity:—
"There is always a danger in extremes, and an exaggeration
of the infectivity of tuberculosis can cause as great harm and
'hardship as the neglect of preventive measures. The medical
profession has not been guiltless in encouraging unnecessary
ostracism of persons with arrested or even quiescent tuberculosis.
"There is evidence that there has been a progressive increase
in the last ten years in the number of children and young adults
who escape infection.
"Although the child in contact with a known infectious
case of tuberculosis runs a six times greater risk of being infected
than one in a non-tuberculous household, there are still from 30
per cent. to 40 per cent. of children living in tuberculous environments
who escape infection up to the age of 14 years.
"Against this apparent low rate of infectivity, we must
place the numerous references in the literature of school children
becoming infected through a teacher with active pulmonary
tuberculosis.
"The evidence before us indicates that the tubercle bacillus
does not infect children so frequently as it used to, in spite of
the fact that tuberculous patients live longer and that there is
only a slight fall in the number of new cases.
"It does not take much imagination to realise that the
ambulant infectious patient will be likely to infect more people
than a bedridden one, whose target area will not be greater than
a semi-circle about six feet in diameter around the bed.
"We must come to the conclusion that it is the age of the
person infected and the magnitude and nature of the primary
infection that is of paramount importance. After that has been