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P = Pulmonary.
NP = Non-pulmonary.
Of the nineteen non-pulmonary cases of infection notified during 1971 cervical glands were
affected in thirteen cases, five more than in 1970 (11 of the non-pulmonary cases were born
outside the United Kingdom). There was one case of tuberculous meningitis and the other five
non-pulmonary cases affected kidney, knee, epididymis, intestine and one case of ischiorectal
abscess.
No fewer than ten of the fifty-three (53) cases where lungs were infected were primary
complexes in young children. This represents an increase of six on the number of primary cases
notified last year and all of them were discovered as a result of investigations carried out among
contacts of other notified cases. Four of the primary complex cases resulted from investigations
carried out when a teacher in one of the Council's junior schools was found to have an infectious
form of the disease. In this particular episode, three hundred and five (305) children were tuberculin
tested and all members of the staff offered chest X-ray examination. On page 110 reference is
made to the Council's decision to make routine chest X-ray examination a condition of service
for all persons whose work involves close and continuous contact with children and this incident
highlights the risks to which young children can be exposed when in contact with infectious
cases of tuberculosis.
Of the 43 adult cases of pulmonary tuberculosis, no fewer than 20 were in the over 55 year
old group and 13 of these had positive sputa confirming the widely accepted view that it is the
older people who continue to form a reservoir of infection within the community.
Several chest physicians believe that the reduction in tuberculosis in England and Wales
over the past quarter of a century has given rise to dangerous misconceptions about the present
level of the disease in the community, some physicians now regarding tuberculosis as rare. The
increase in the number of notifications received by this Department during 1971 is due chiefly
to the greater number of non-infectious glandular cases notified and to the success of tuberculin
surveys carried out among contacts which brought to light 10 primary cases of infection. Clearly
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