[Report 1960] / Medical Officer of Health, Merthyr Tydfil County Borough.
- Merthyr Tydfil (Wales : County). Borough Council.
- Date:
- 1960
Licence: Attribution 4.0 International (CC BY 4.0)
Credit: [Report 1960] / Medical Officer of Health, Merthyr Tydfil County Borough. Source: Wellcome Collection.
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![more commonly, simply an exceptional individual sensitivity to tuberculin. In view of this it is recommended that should a grade 3 or 4 reaction occur chest X-ray is advisable. At the other end of the scale is the negative reaction, which points clearly to an absence of intimate contact with the disease. It is well known that in most infections, such as measles or chicken-pox, the illness, however mild, usually protects against a further attack. This is, at least, the basis of all vaccination pro- cedures, for in place of the active disease, the killed (or modified) germ is used, e.g., as in whooping cough or poliomyelitis vaccin- ation. The tuberculosis vaccine is B.C.G. (Bacille Calmette- Guerin) which is an altered type of bovine T.B. germ and is harmless. When given, it converts a tuberculin negative person to tuberculin positive, as would be anticipated and is to date, the most effective known method of bestowing any degree of active immunity upon a susceptible person. As tuberculin conversion is to some extent a measure of active immunity, non-reacting young persons are vaccinated. The technique involves the intro- duction of 0.05 ml. of the reconstituted freeze-dried vaccine into the skin at two sites into the left arm just below the shoulder. The local reaction is simply scabbing at the injection sites which is soon followed by the formation of two small scars, as in vaccin- ation against smallpox. 3. Procedures Adopted. From the theory of tuberculin testing and B.C.G. vaccination already described, it is seen that certain guiding principles emerge which may be adopted in the investigation of any school popula- tion, when it is required to determine the actual source of the disease and to ascertain those most vulnerable. The procedures were :— (1) A circular letter to all parents, explaining the finding of a case of pulmonary tuberculosis in the school and the desir- ability of adequate investigation. (2) Tuberculin skin-testing of all those pupils for whom per- mission was obtained. 1 (3) Classification of skin reactions according to the Heaf Grades. ] (4) B.C.G. vaccination of negative reactors. : (5) Full-size chest X-ray at the Chest Clinic of all Grades 3 and I 4 reactors. (6) Follow-up investigation of suspicious cases by the Chest Physician and treatment when required. (7) Explanatory talk to the teaching staff regarding the desire ability of chest X-ray. (The skin-testing of adults is of no value here).](https://iiif.wellcomecollection.org/image/b28859820_0055.jp2/full/800%2C/0/default.jpg)
