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

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Southall 1958

[Report of the Medical Officer of Health for Southall]

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in the trial. Between September, 1950, and December, 1952, approximately 60,000 of these
children entered the scheme. All were X-rayed on entry and after preliminary skin-tests a
proportion of the children were vaccinated with one of two tuberculosis vaccines. Since then
these young people have been followed up to find out if the vaccines have in fact prevented
tuberculosis. A regular postal enquiry form has been sent to each participant and a regular
visit to the home has been made by one of the nurses on the staff of the Local Health Authority
concerned. The visits by the nurses have been especially valuable since it has been possible
to remind the volunteers and their parents of details about the scheme as well as to get
essential medical information.
These home visits, which have been carried out in addition to the normal duties of the
nurses, have been very successful; much credit is due to the nurses concerned for the able
and conscientious way in which this work has been done. A further feature of the follow-up
has been the provision made for the regular X-raying of the participants. A mass radiography
unit from the Medical Research Council has visited the areas at regular intervals and
participants have been invited to attend for X-ray in the evening.
By 1956 the findings showed that B.C.G. vaccine confers a substantial measure of
protection against tuberculosis and the first report of the investigation was published in 1956.
As a result Local Health Authorities in England and Wales have been encouraged to offer
vaccination to thirteen-year-old children and it is probable that this measure will effect a
considerable reduction in the frequency of tuberculosis in young people in future.
During 1958 one visit was paid to Brentford clinic by the mass radiography unit.
Eighteen young people from Southall were invited to attend and of these 13 attended and
had an X-ray.
Although the investigation has shown the vaccine to be effective it is desirable to know
whether protection only persists for a few years after vaccination or whether such induced
resistance lasts for a considerable period. The investigation is, therefore, being continued
for the present.
Research into Incidence of New Tuberculosis in the Adolescent
In previous reports this piece of research has been described, the purpose of it being to
ascertain the amount of tuberculosis occurring during the first years in industry or office life
of young persons. This is now the sixth year of the experiment and up to date no active cases
have been found amongst adolescents taking part in the investigations in Southall.
Tuberculosis in Indian Immigrants
An interesting report has recently been published (Tubercle, Lond., (1959), 40, 387) by
Doctor J. T. Nicol Roe, and is included herewith:—
Since 1954 the borough of Southall, an industrial area, with a population of 53,000,
within the purview of Uxbridge Chest Clinic, has experienced an influx of Indian immigrants;
in 1958 they were estimated to be about 1,050. Between 1954 and 1958 there was also a
steady increase in the number of Indians notified each year as suffering from tuberculosis;
by the end of 1958 the total had reached 40, enough to call for further investigation by the
health authorities, particularly with regard to prevention. Treatment presented little
problem as there were sufficient beds in hospitals and sanatoria to accommodate them.
The case records of 35 patients (32 males, 3 females) were available for analysis. Five
patients had left the district.
Primary Lesions
Ten patients had obvious primary lesions with manifest lymph node enlargement; a
further 4 had pleural effusions. There was also 1 who developed miliary tuberculosis without
an evident primary complex; 2 of the patients with an obvious primary complex also developed
miliary lesions.
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