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B.C.G. VACCINATION. Towards the end of 1950 the Medical Research Council began a
controlled experiment with school leavers. The main object of the research was "to
determine with precision tuberculosis mortality arising in each of the groups of the trial
in the years following their first examination for the trial". West Ham children took part
in this investigation, and the procedure was described in some detail in my last report.
All children taking part in the trials, both positive and negative reactors to the skin test,
are being followed up for three years, and are being offered an annual X-ray examination and
a repeat tuberculin test. The medical research Council Team visited West Ham in June 1954
for the second annual X-ray and tests of the school leavers Christmas 1951, Easter and
Summer 1952. Approximately 600 home visits were made by the school nurses during 1954. So
far, a satisfactory proportion of the boys and girls have remained in the trials and much
of the credit for this is due to the painstaking work of the school nurses and health
visitors who visit the children once a year in an attempt to sustain their interest and to
enquire about their health at the time of the visit and during the previous interval. The
head teachers of the schools also co-operated splendidly in making the scheme a success.
The results of the trials will not be known for some time and it is not yet certain exactly
how much benefit in the way of protection from tuberculosis can be expected from B.C.G.
vaccination of school children. The object of the vaccination of the non-reactors to the
skin test is to produce in them a controlled primary focus of attenuated infection, with
consequent development of acquired immunity, instead of allowing them to risk the dangers
which are inseparable from natural, uncontrolled exposure to infection by virulent tubercle
bacilli in large numbers. One cannot be dogmatic at this stage about the probable results
but the evidence suggests that B.C.G. vaccination probably affords a useful degree of
protection to supplement all the other measures employed in the control of tuberculosis.
The Medical Research Council has extended its thanks to all who helped and co-operated in
the scheme.
REPORT ON THE WORK OP THE SCHOOL DENTAL SERVICE
The Senior Dental Officer was not able to submit a report on the service as he died
early in May: his loss was referred to in the last report. His successor commenced duty
on 10th November and so has not had time to prepare a report on the year's work.
Towards the end of the year a start was made in carrying out dental inspections in the
schools, but owing to shortage of staff this was restricted to infants and Juniors. It is
hoped, however, that a systematic inspection programme will be possible in the future.
Several dental officers were employed during the year, some full-time, some part-time,
and as a result the amount of dental work was maintained at its previous level. There was
an improvement in one respect; a substantial increase in the number of fillings, from 1,136
in 1953 to 3,491 this year. The greater proportion of these fillings were in permanent
teeth. The principal objective of the school dental service is the preservation of the
permanent dentition; but in order to achieve that objective it is necessary also to preserve
the temporary teeth to build a framework of healthy mouth and Jaws in which the permanent
teeth can develop. To that extent, conservative work on temporary teeth, though rather time
consuming, is to be preferred to extractions whenever possible.
The number of administrations of general anaesthetics (nitrous oxide and oxygen)
remained about the same as in the previous year - there was a comparatively small reduction
in the number of extractions - 6,756 against 7,311.
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