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A summary of the work of the-West-Ham Chest Clinic in this respect has kindly been
contributed by Dr.D.J.Lawless, the Consultant Chest Physician.
Number of school children referred by school medical officers 12
Number of school children referred by general practitioners 103
Number of school children examined as new contacts 136
Number of school children found to be suffering from tuberculosis 15
The classification and disposal of the definite cases is set out below:-
Respiratory
Non-Respiratory
Active primary pulmonary tuberculosis
4
Cervical glands
1
Tuberculous pleural effusion
5
Adult type of pulmonary tuberculosis
5
These 14 respiratory and 1 non-respiratory cases were admitted to hospital.
B.C.G. VACCINATION. Prophylaxis against tuberculosis using the live vaccine
containing B.C.G. (Bacille Calmette-Guerin) has been extensively practised since the
vaccine was introduced more than thirty years ago. Although millions of such vaccinations
have, by now, been carried out in various parts of the world, few controlled trials have
taken place to assess the value of the vaccine as a preventive measure. In September, 1950,
the Medical Research Council began a controlled clinical trial 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".
The object was to study what contribution B.C.G. vaccination might make to the problem of
tuberculosis in children leaving school and entering upon the adult environment of work,
i.e., a time of life at which the incidence of tuberculosis begins to rise in the highly
industrial community of Britain. West Ham children In their final year at secondary modern
schools and nearly all of whom were aged between l4½ and 15 years, took part in this
investigation and the procedure was described in some detail in my report for the year 1953.
All children taking part In the trials, both positive and negative reactors to the
intracutaneous skin test, are being followed up for some years, and are being offered an
annual x-ray examination and a repeat tuberculin test. The Medical Research Council Team
visited West Ham In May, 1956, for the fourth inspection of Easter and Summer leavers of 1951.
Approximately 868 home visits were made by the school nurses during 1956.
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 keenness and good work of the school nurses and
health visitors who visit the people (now young adults) 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. This work, which has often Involved making repeated visits, has been
painstakingly carried out, and the interest of the volunteers and their parents in the trial
and their response to the invitation for x-ray, are a reflection of the effort made. The
trial is still in progress and the first progress report presenting preliminary results after
each participant had been in the trial for two and a half years, with supplementary incomplete
information up to four years, was issued in the early part of 1956. The following is an
extract from the summary (as it relates to the full trial).
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