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The figure of 76 notifications includes 26 inward transfers i.e. cases
notified because they had removed into the borough but who had previously contracted
the disease elsewhere. This leaves a total of 50 new cases of tuberculosis
occurring within the borough, and this figure is only one more than in
1957.
Facilities for diagnosis and treatment of pulmonary tuberculosis as well
as prevention and after care are provided by the Hounslow Chest Clinic, and
home visiting is carried out by Health Visitors attached to this Clinic. They
are also responsible for the examination of contacts and for the B.C.G. inoculation
for the prevention of tuberculosis. B.C.G. inoculation is now offered
to all the Mantoux negative, i.e. susceptible contacts of newly discovered
tuberculosis cases; 63 residing in this Borough were inoculated during 1958.
A prominent part in the treatment is played by domiciliary chemo-therapy
(i.e. treatment with suitable drugs or injections given at home) on the recommendation
of the Chest Physician, with the aid of the Home Nurses (formerly
District Nurses) provided by the Middlesex County Council.
Apart from institutional treatment provided by the local Hospital Management
Committees of the North West Metropolitan Regional Hospital Board in General
Hospitals and in chest Hospitals, there is also a Middlesex County Council
Hostel for chronic ambulant male tuberculous patients.
Facilities for convalescence, rehabilitation and training are provided by
the Middlesex County Council and the North West Metropolitan Regional Hospital
Board.
The social side of the treatment and prevention of pulmonary tuberculosis
is dealt with by the Welfare Department of the Hounslow Chest Clinic.
Tuberculosis Vaccines Clinical Trial
During 1958 the Tuberculosis Vaccines Clinical Trial continued. In the
Autumn of 1950 the Medical Research Council, in conjunction with many local
authorities in North London, the Midlands and the North of England began a national
investigation into the value of vaccination against tuberculosis. In 1950
B.C.G. vaccine was known to be of mass value to those in contact with the disease
for example nurses, and children living in the same home as a case of
tuberculosis. However, there was disagreement as to whether the vaccine should
be used on a wide scale for children who were not contacts.
A clinical trial was therefore begun to assess the contribution likely to
be made to the prevention of tuberculosis by widespread vaccination. Children
who at that time were aged fourteen and were in their last terms at Secondary
Modern Schools were invited to take part 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.
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