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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, where cases of
tuberculosis are now isolated in a special ward, and a Mass Survey by X-ray has been
carried out during the year. It is hoped that the risk of undiscovered cases remaining in the
general wards has been greatly lessened by these provisions.
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 1956 was 71.
Other matters referred to in the Chest Physician's report are that there seems to be again
a general rise in the incidence of new tuberculosis, and that the statistics show the occurrence
of the disease still to be greatest in the younger age groups and highest in ages 15.24. There
also appears to be a rise in the numbers of cases occurring in the over forty-five's. Disappointment
is expressed that in spite of all the propaganda and endeavours to obtain cases
of tuberculosis in the early stages it is still found that one in every ten discovered has
already extensive lung involvement and only four out of every ten discovered are really
early cases. Also the number of cases developing as a result of contact of some years
distance does not appear to lessen.
An appeal is made by the Chest Physician who would like to stress the importance of
continued co-operation of the public, with particular regard to chest X-ray and B.C.G.
vaccination, for the eradication of pulmonary tuberculosis, which seems to have become a
possibility in our lifetime.
Tuberculosis Vaccines Clinical Trial
The first report of the Medical Research Council's investigation into the value of
vaccination against tuberculosis was published during the year. Southall has been cooperating
in this investigation since its beginning in 1951. The first report of the
investigation has shown that vaccination for children in their fifteenth year substantially
reduces the risk of contracting tuberculosis in adolescence.
Background of the Investigation:
The value of vaccination against tuberculosis has been a matter of dispute since its
introduction into France more than 30 years ago. During this time there has been a gradual
accumulation of evidence in favour of the vaccine, and by 1949 its value for those exposed to
special risk from tuberculosis, such as nurses and contacts with cases of the disease, was
generally recognised. In 1949 vaccination for contacts was authorised by the Ministry of
Health, and in 1953 vaccination in older school children was introduced at the discretion of
each local health authority. However, until the extent of the contribution which B.C.G.
vaccination might be expected to make could be accurately assessed, many public health
authorities considered that its introduction on a wide scale was not justified, particularly
in view of the recent advances made in other aspects of tuberculosis control.
The first report establishes beyond question the short-term value of B.C.G. vaccination
of young people in this country, and shows that vaccination at the age of 14 and 15 should
reduce the number of cases of the disease developing between the ages of 14 and 17 by about
half. This represents a valuable contribution to the prevention of tuberculosis.
Description of Investigation:
The effort to establish the value of these vaccines scientifically has necessitated an
extensive investigation, probably the most detailed of its kind ever undertaken. The success
achieved has been made possible by close co-operation of Medical Officers of Health and
Chest Physicians in many parts of Britain with the Medical Research Council.
Beginning in 1950, three special Medical Research Council teams, each equipped with a
mass X-ray unit, visited 22 North London boroughs, including Southall, and towns in the
Midlands and North of England, With the consent of the parents school children in their
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