[Report 1954] / Medical Officer of Health, East Sussex County Council.

  • East Sussex (England). County Council
Date:
1954
Catalogue details

Licence: Attribution 4.0 International (CC BY 4.0)

Credit: [Report 1954] / Medical Officer of Health, East Sussex County Council. Source: Wellcome Collection.

    16/46 (page 12)
    The deaths from tuberculosis in 1954 were as follows:— Pulmonary Tuberculosis:— Urban Districts Rural Districts Other forms of Tuberculosis:— Urban Districts Rural Districts Deaths. 26 17 I o 44 During 1954, 43 deaths in which tuberculosis of the respiratory tract was mentionec as a factor included 13 (30%) which had not been notified. Eight of these were retiree persons, two were inmates of a mental hospital, two were widows, and one was a 21 months old baby. This last case was picked up as a contact, but the parents refused consent fo treatment until too late. There were no non-notified non-pulmonary cases. The necessity for notification of every case of tuberculosis, whether or not he move about the country, can be illustrated by the following two cases:— [a] A man who had lived abroad sought the advice of a specialist in London, by whor treatment was started but who did not, as far as is known, notify the case. He soon move( to an address in this county, where the treatment was continued by the local genera practitioner at the specialist’s request. The family was known to the Department as on where a baby born soon after their arrival was regularly visited, but it was only on th occasion of her last visit just before the family’s departure that the health visitor, to he astonishment, was given the information that the father had a spot on the lung and wa shortly to be admitted to sanatorium. At this late stage suitable enquiries and examinatio of contacts were arranged on behalf of the adjacent health authority, to which the famil had moved. The general practitioner had failed to notify solely on account of a hona fia idea that being once known and presumably notified elsewhere no further duty existed. It is still not sufficiently known that according to the series of regulations on th subject through the years since 1913, a case of tuberculosis should be notified in eac sanitary district; moreover, the latest regulations (those of 1951) omit for the first tim the previous proviso which excused the doctor knowing of a case from notifying if he hai-: reason to believe it had already been notified. [h) A master in a school was found to have a tuberculous cervical gland, but the cas was not notified nor were there any of the usual informal approaches from officers of on service to those of another. Notification did not take place until some weeks later, afte the attention of the general practitioner had been drawn to the omission, and seems t have fallen by default among three consultants, one or two general practitioners, and a least one hospital resident. Fortunately, the chest check up which was made at an earl stage showed that the patient was reasonably safe, but it is, to say the least of it, a littl embarrassing when those concerned with public health and school health are not aware ( such a case in the service of their own Education Committee. Follow-up of Contacts. 216 new notifications were received during the year I95<: 844 contacts were examined and 26 (3.08%) were found to be tuberculous. The “ contac to new case ratio ” is therefore 4:1. A special survey was carried out at a school as a result of a canteen worker discovere to have pulmonary tuberculosis. Of the 403 children, the parents of only 32 refused t have their children tested. 364 children were Mantoux tested and 360 were subsequent! X-rayed. 27 staff (the whole roll) were also X-rayed. Two children with tuberculoi lesions were found, one a primary complex in lung with no general symptoms and or other, neither of whom could reasonably be attributed to infection from the cantee worker. A close relative of the first soon afterwards died of tuberculosis as a hithert unknown case, the family being not very receptive to medical approaches, and there reason to believe that the second child was also a form of home contact.