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During 1954, B.C.G. vaccination was introduced for a section of the
school population by the Local Health Authority. Previously this B.C.G.
vaccination has been reserved for doctors, nurses, close contacts of cases
of tuberculosis, and those whose work brings them into close association
with persons suffering from tuberculosis. Briefly, the scheme is to offer
to all school children, just prior to their 14th birthday, the opportunity
to have a test (the Mantoux test) to show whether they have come into
contact with the disease, and have thus acquired immunity, as shown by
a positive reaction to the test, or whether they have had no opportunity
of developing antibodies to tuberculosis. Following the test, those children
who are negative are given B.C.G. vaccination; that is, an immunising
dose of a special variety of modified tubercle bacilli, which will produce
the same immunity as if they had had a primary infection, which they
had combated and thrown off during the normal course of their lives.
The Government have decided that the group of children who are
most susceptible are young adolescents leaving school and entering new
conditions in business and industry. Observations On the incidence of
tuberculosis have shown that the adolescent period is one of the most
susceptible in a person's life, and the Government feel that this group
should be specially selected for protection. In December 1954, of the
246 school children to whom this service was offered in Beddington and
Wallington. 127 accepted and were Mantoux tested, and 110 were immunised.
With regard to treatment, just after the war the emphasis was upon
surgical removal of infected lung tissue, and striking results were obtained
by modern surgical techniques, assisted by antibiotic drugs. It was
thought at that time that surgery would play a more prominent part
in the treatment of tuberculosis than medicine, and it will be recalled
that Regional Hospital Boards made every effort to secure more hospital
beds for thoracic surgery. In particular, a move was made to secure the
Carshalton, Beddington and Wallington District (War Memorial)
Hospital for this specific purpose. The popular outcry, however, which
was raised at this suggestion persuaded the Regional Hospital Board
to give up this project. It is interesting to note that since that time the
medical treatment of tuberculosis has been revolutionised by the introduction
of three new drugs: PAS, streptomycin and isoniazid.
With the advent of these new medical armaments, while surgery will
undoubtedly play an important part in some cases of the disease by
eradicating diseased lung tissue, its place is subordinated to the medical
treatment of the patients. As a result, there is not now the same demand
for beds for thoracic surgery.
Mass Radiography continues to play a very important part in the
early detection of the disease, and with the brighter prospects held out
to patients through improved medical treatment and immunisation, many
observers in this field consider that within the lifetime of many now living,
tuberculosis may possibly, in Western civilized communities, show as
spectacular a fall in incidence as has diphtheria as the result of diphtheria
immunisation.
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