Report of the Commission of Public Health to the Minister of Public Health / Department of Public Health, Victoria.

  • Victoria. Commission of Public Health.
Date:
[1951]
Catalogue details

Licence: Public Domain Mark

Credit: Report of the Commission of Public Health to the Minister of Public Health / Department of Public Health, Victoria. Source: Wellcome Collection.

    18/96 (page 18)
    General. Reports of tile various activities of the Tuberculosis Branch, and statistical tables, are attached. ESMOND V. KEOGH. Director of Tuberculosis. CLINICAL AND BUREAUX SERVICES. Central Chest Clinic and Tuberculosis Bureau, Melbourne. Deputy Director of Tuberculosis : Diagnostic Services ; Dr. H. M James. The Chest Clinic continues to function to its full capacity. Early in the year the Chest Clinic Extension was brought fully into service and four medical officers are now fully employed. Between one hundred and one hundred and twenty patients are seen daily, and it will be seen from the accompanying figures that the daily average of X-rays is seventy-five. Patients referred by outside medical practitioners keep up in numbers and can now be seen without delay. We have not yet reached the state where the supply of beds, particularly for middle-aged males, has satisfied the demand and it has been necessary to add to the existing domiciliary medical and nursing services. Outside visiting is being clone twice weekly by medical officers from this clinic, and some chemotherapy is now given by the visiting nurses, under the direction of medical officers. We have not yet attempted a domiciliary artificial pneumothorax service. For the benefit of the suburban medical practitioner who may be in difficulties with his tuberculosis patients, we are now able to offer the services of a highly qualified and experienced medical officer for consultation. This service appears to be appreciated by the medical men concerned. This year, periodical conferences have been held at this Clinic, attended by the surgical specialists and staff of Sanatoria. These meetings have been open to members of the medical profession and problems of diagnosis, control, and surgery have been discussed. Some interest has been shown by the outside profession. The B.C.G. Clinic is in action two full days weekly, mainly for the benefit of contacts. From 30 to 40 children are being immunized weekly, which is the average new number of contacts expected. Mantoux conversion has been practically 100 per cent, and there have been no complications beyond a few minor cases of adenitis. As far as we have been able to ascertain there have been no cases of tuberculosis developing amongst the children immunized here since the inception of the clinic. The X-ray Department has taken 18,820 films and 7,000 micro films during the year, a total of 26,820. In addition to the routine work of the Central Chest Clinic, all radiography for Mint-place Annexe and for bone and joint conditions from Green vale and Heatherton Sanatoria is done at this Chest Clinic. Chest Clinic and Tuberculosis Bureau, Bendigo Base Hospital, Bendigo. Tuberculosis Officer : Dr. K. G. Kerr. There were 39 notifications of tuberculosis in the Northern Health Area, 20 of these being from the City of Bendigo, and 19 from the rest of the Area. Seventeen of the notifications were from the Bendigo Chest Clinic, 16 from various hospitals—Bendigo Base Hospital, Mildura Base Hospital, Heidelberg Repatriation Hospital, and the Children’s Hospital—and 6 from private practitioners. In 1949 there were 75 notifications, the increase that year being due to a visit to Bendigo by the Division of X-ray Surveys near the end of the previous year, and consequent notifications from the Chest Clinic. Twenty of the 39 notifications this year were of persons over 40 years of age. There were 31 males and 8 females. Of 25 pulmonary cases, whose stage of disease at notification is known, only 3 could be said to be in the first stage. One notification was of tuberculous meningitis in a child of 20 months, of Kerang, who subsequently died. There were 14 deaths from pulmonary tuberculosis and 1 death from tuberculous meningitis. Of the pulmonary cases, 12 were males and 2 females. Ten of the pulmonary deaths were of residents of the City of Bendigo, thus giving a death-rate of 3 6 per 10,000 of estimated population of 28,000. Last year the rate was 5-6 and in the five-year period 1941-1945 Bendigo had a death rate from pulmonary tuberculosis of 5 • 9 per 10,000 as compared with rates of 4-l for Melbourne, 4-0 for Ballarat, and 3-5 for Geelong. Two deaths were of persons who were not known to the Chest Clinic as cases of pulmonary tuberculosis before death. Eleven of the 14 deaths from pulmonary tuberculosis were of persons over 50 years of age, 3 persons being over 70 years. One male was aged 40 years, 1 male was aged 36 years, and 1 female aged 27 years. This follows the general trend of recent years, where notifications and deaths in young people have shown a marked reduction. Only 2 deaths occurred among patients in the Chalet. Attendances at the Chest Clinic again show an increase, mainly as a result of B.C.G. vaccination, for which sessions for testing and vaccination have been held about once a month. In addition, vaccination was carried out at the Teachers’ Training College, Bendigo High School, and Bendigo Girls’ School. Trainee nurses at the Northern District School of Nursing also were vaccinated. B.C.G. Vaccination for 1950. Number of people vaccinated at Clinic .. 352 Vaccinations in secondary schools .. .. 350 Vaccinations of student teachers .. .. 86 Total number vaccinated .. .. 788 Number not re-tested .. .. .. 477 Number converted, of 311 tested .. .. 290 Number re-vaccinated . . .. .. 18 Number of these converted .. .. 15 Number of these not re-tested .. .. 2 Number still negative .. .. .. 1 Number of convertors still positive after twelve months, of 67 tested .. .. .. 60 Reactions to vaccination have been mild. They have ranged from papules of 3 to 5 m.m. diameter to pustules of 5 to 12 m.m. diameter. In those examined at the Clinic there has been a complete absence of anything in the nature of ulceration or a “ bad arm Of those done at schools which were not inspected, I have received no reports of any untoward reactions. A Mantoux-test survey of children was conducted in Bendigo. This was a repetition of the survey made in 1948, except that this time there were fewer pre-school children brought for testing and also fewer of the 12-17 age group, as only two secondary schools were visited late in the year and one of these only for the purpose of vaccinating the 15-17 age group. There is a close similarity in the percentages of reactors in the two surveys. Only one new active case of pulmonary tuberculosis, that of the father of a family in which all children reacted, was found as a result of this survey. Generally, those who reacted in 1948 are shown to react again in 1950, only two children having reverted to a negative state. A few have converted to positive during the interval. Those of the two upper grades in 1948 have, of course, passed out of the schools.