[Report 1956] / Medical Officer of Health, Leeds City.

  • Leeds City Council
Date:
1956
Catalogue details

Licence: Attribution 4.0 International (CC BY 4.0)

Credit: [Report 1956] / Medical Officer of Health, Leeds City. Source: Wellcome Collection.

    63/252 (page 41)
    These results may imply that our previous conception and interpretation of the epidemiological features and pathogenesis of tuberculosis need revision and re-assessment and that our main effort in the prevention of tuberculosis should be applied at the early stage of preventing, overcoming or energetically treating the primary tuberculous lesion, rather than concentrating on the management, treatment and after-care of the established case of active post¬ primary re-infection adult-type pulmonary tuberculosis. Whatever else may emerge from these figures, one thing is certain—tubercu¬ losis is by no means a fast disappearing disease. Almost as many new cases are appearing now as appeared ten or twenty years ago. The type of disease may be less severe and the mortality rate is un¬ doubtedly falling and has been for at least the last 80 years with an added impetus in the last io years due to modern methods of treatment. Tuberculosis still remains an infectious communicable disease from which the tuberculin-negative reactor stands in peril. Therefore the need for isolation of the infectious patient and for sustenance and observation of his child contacts will remain for many years to be the keystone of any effective preventive programme. The attack-rate of tuberculosis has shown a reduction of 25 per cent, on the 1936 figures but the death-rate during this score of years has fallen from 0-83 per thousand population to 0-13 per 1,000, which is equivalent to a reduction of 84 per cent, on the 1936 rate. This is indeed a dramatic fall, the greater part of which has occurred in the last 10 years in which the reduction has been equivalent to a fall of 78 per cent, of the 1946 mortality rate. Case-Finding Methods.—Of the 413 new cases of respiratory tuberculosis notified among Leeds residents during the year, 331 were notified by the Chest Clinic staff. The effectiveness of the various methods of finding new cases of tuberculosis is shown in the following table :— Method No. of new patients investigated No. of new cases of pulmonary tuberculosis found Ratio G.P. letters 1,976 151 76/1000 Exclusion X-Rays Routine X-Ray for other 4,OI4 83 21/1000 purposes 149 3 20/1000 Contact examination 2,189 26 12/1000 M.M.R. 31,015 47 1-5/1000