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Mount Pleasant Hospital, which is for tuberculous patients only, is under the
supervision of the Chest Physician, and the amount of preventive work carried out there,
both in teaching the patients the rules of hygiene in preparation for their discharge into
the outside world, and in the tracing and training of contacts of patients, is most valuable.
Close co-operation is now maintained between the Chest Clinic and St. Bernard's Hospital,
and, with the opening of the new tuberculosis ward there, and the increase of X-ray
facilities, it is hoped that the risk of undiscovered cases remaining in the general wards
will be eliminated.
At the Chest Clinic when contacts of cases of tuberculosis are found to be susceptible
to the infection they are given preventive inoculation of B.C.G. (Bacillus Calmette-Guerin).
The number of Southall contacts so treated during 1955 was 86.
Tuberculosis Vaccines Clinical Trial. Information has been obtained with regard to
the successful outcome of this piece of research in which Southall young people took part.
The report received from Dr. Pollock, of the Medical Research Council, is as follows:—
During the last few years the Medical Research Council have been engaged in an
extensive investigation to determine whether two tuberculosis vaccines are sufficiently
valuable to be used on a mass scale in this country for the prevention of tuberculosis. 22
North London boroughs, including Southall, and also areas in the Midlands and the
North of England are taking part.
The vaccines used in the investigation are B.C.G. vaccine, which was introduced
more than 30 years ago, and a more recent introduction, vole vaccine. Although B.C.G.
vaccine has been used for many years in Scandinavian and other countries, it has been
difficult to assess its value. Death rates from tuberculosis have been reduced in countries
where the vaccine has been widely used, but this decline has been influenced by such things
as better housing, better nutrition, and advances in the treatment of tuberculosis. Also,
equally good results in the prevention of tuberculosis appear to have been achieved in
some communities where the vaccine was not widely used. Thus, to assess the contribution
which the vaccine would make to the prevention of tuberculosis it has been necessary to
undertake a clinical trial.
Between September, 1950, and December, 1952, school children in their last term at
Secondary Modern schools were invited to take part in this clinical trial. Those who
joined were X-rayed and skin tested, and a proportion of the selected susceptible children
were given either B.C.G. vaccine or vole vaccine. Approximately 60,000 young people
joined the scheme, of whom roughly 200 came from Southall. Since then it has been
essential to keep in touch with the participants to determine if the vaccines were preventing
the disease. This has been done by postal enquiries, home visits by Health Visitors and
regular X-rays. In addition much assistance has been given by the chest clinics and hospitals
in the areas concerned.
The follow up has so far been very successful. Over 80% of the postal forms have been
returned and more than 95% of the homes regularly visited. Approximately 75% of the
young people have taken advantage of the regular X-rays. As a result of this intensive
follow up, the investigation has already shown that both vaccines confer a substantial degree
of protection in adolescents at least for four years after being given. It is now likely that
tuberculosis vaccination will soon be offered to all young people in their final terms at
school in Britain, and that tuberculosis in young people will be considerably reduced as a
result.
The investigation is being continued and it is hoped to find out by continuing to keep
in touch with the participants how long protection from the vaccine now lasts, as well as
other information which will help to prevent tuberculosis. The co-operation of all
concerned has been an important feature of the investigation. It is hoped to continue this
co-operation during the next few years.
Research into Incidence of New Tuberculosis in the Adolescent. Details of this
scheme were reported last year, and up to the end of December there was no new
information, the next batch of young people not falling due to be X-rayed until mid 1956,
by reason of the scheme of selection being altered slightly. The boys and girls are not
now being X-rayed as school leavers, but twelve months after leaving school since it was
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