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The analysis of the housing conditions of new cases (of notified patients living in
Southall, exclusive of St. Bernard's Hospital notifications) shows in ten cases statutory
overcrowding, eight occupied by Indians, and two by families other than Indian. No
abatement of the overcrowding had been obtained by the end of 1960.
In fourteen instances there were multiple cases, six in English homes, and eight in
Indian ones. Statutory overcrowding was confirmed in three of these houses. The
number of patients was two in nine cases, three in two cases, but six members were affected
in three houses—in each case these were Indian houses.
Work on enforcing the standards for houses in multiple occupation should help to
reduce this hazard—and longer retention in hospital must be obtained for infectious
persons.
Of three cases of overcrowding with tuberculosis in 1960, abatement had occurred in
all three instances; in one instance of dilapidated housing with tuberculosis, no rehousing
had taken place by the end of the year.
In the case of overcrowding remaining from 1958—the family has now removed.
Management of Tuberculosis
For diagnostic purposes, Southall patients are mostly referred either by general
practitioners or from hospital doctors to the Uxbridge Chest Clinic, and if tuberculosis is
found, treatment and following-up is instituted from that Clinic. The Tuberculosis Visitor
calls at the home of a patient and submits a copy of her report to the Public Health Department.
Contacts are seen by the Visitor and they have suitable tests, either tuberculin
tests or X-rays, or both, at the Chest Clinic. If sanitary defects or overcrowding are
reported further visiting is carried out from the Public Health Department.
At St. Bernard's Hospital, cases of tuberculosis are isolated in Adelaide Ward, which
has 24 male and 24 female beds. One of the doctors from Uxbridge Chest Clinic continues
to carry out tuberculin testing and B.C.G. vaccination of members of the nursing staff of
the hospital.
B.C.G. vaccination
B.C.G. vaccination is offered to contacts of cases of tuberculosis, to medical and
nursing staffs of tuberculosis wards, and since 1957, as a result of the findings of the Medical
Research Council in their Tuberculosis Vaccines Clinical Trial, to children aged 13 and over
in Southall schools. Testing with tuberculin is carried out beforehand. The tuberculin
test, if positive, shows that infection has occurred at some time during life, and further
investigation is undertaken to verify whether this is active, chronic or healed infection, as
these all give the same result to the test. When the tuberculin test is negative and in the
absence of disease, B.C.G. inoculations are carried out in order to render the individuals
tuberculin positive and, therefore, to have immunity to infection by the tuberculous bacillus.
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