THREAT TO Tb. CONTROL

Chronicle (Levin), 12 April 1949, Page 6

THREAT TO Tb. CONTROL

Press Association)

Call For Thorough Test-Of All Immigrants

(Per

AUCKLAND, April' 11. Described as the most sinister threat to the whole tuberculosis control programme in New Zealand, the incidenc/& of pulmonary tuherculosis among immigrants arriving in the Dominion resulted tonight in a demand from the Auckland Hospital Board for vigorous .action by the Government. The board protested against the lack of medical examinations of immigrants before emharkation. In a res'olution moved hy the chairman, Mr. J. Grierson, the board recommended that no person, whether assisted immigfant or not, should be permitted to embark for New Zealand unless within two months of emharkation he had received an X-ray examination of the chest which indicated freedom from pulmonary tuherculosis. The Health Department was asked to take immediate steps to frame regulations for a more thorough examination of immigrants landing in this country and to give special consideration to means to be taken to deal with visitors and tourists. An examination of the records at the Green Lane chest clinic showed that 31 immigrants had been treated for tuber culosis in the past 24 years, said Mi. Grierson. The Health Department had advised that only one of these was an assisted immigrant but this did not alter the position as the matter had been brought to the notice of the Department and Government on severa! occasions. These cas^s were those reported in only one hospital board district, a district which contained onefifth of the population of New Zealand, said Mr. Grierson. There was litth'* doubt there must be a very mucb greater number of such cases through out the country. How many others these people might have infected while e'n route to New Zealand and sinee their arrival, must remain unknown. The physician in charge of the chest clinic, Dr. Chisholm McDowell, had referred the matter to the Health Department and it had been discussed at the last two conferences of tuberculosis medical ofticers, eontinued Mr. Grierson. Lt was understood that a recommendation to the Health Department stated that all prospeetive immigrants should have a coinpulsory X-ray examination^ of the chest shortly before they em-" barked. Iiowever, the Department apparently did not act on this recommendation because cases of pulmonary tuberculosis eontinued to arrive in New Zealand. "The cases already known at the clinic probably represent only a proportion, perhaps quite small, of the existing cases of * open infectious tuberculosis disease in immigrants,"" reported Dr. McDowell. "Attention should be drawn to the faet that many . of these pntients were almost certainly ip the infectious state while journeyin,g to New Zealand and the crowded com ditions known to exist in many immigrant ships, doubtless exposed many others to the risk of infection. Close confinement in a ship board cabin fdr four to six weeks, with an unreeognised open case of pulmonary „ tuberculosis, would be tantamount to a death sentence for infants and a serious hazard for both adolescents and adults. All these patients have required medical attention and the majority have occupied or are in the near future likely to occupy beds in hospital," eontinued Dr. McDowell. " Approximately one-third of these cases have been admitted to hospital very shortly after arrival in this country and one at least has already occupied a bed for over two years. There is every reason for believing the the disease in each case would have been recognised on a routine X-ray before embar.kation. In som6

cases ©vidence of grosk disease ■■ should have- been apparent on Ihe most perfunctory medical examination." .- The Director-G'eneral of Health, Dr. T. Kitch-ie stated that a medical examinatioh was gi-v'en in the United Kingdom to all assisted immigrants and that X-ray exaniinatious were made of those vvho were to u'ndertake hospital nursing or home aid work land when the exarninihg doctor was hotK-satisfied that the chest was clear, usually embarkation was not more than six months after the (inal acceptance of! the immigrant. There was no such pfocedure for unassisted_ immigrants. '^s ' 1 •> ' ' The "proposals for the. X"-rayihg "Of all .a.ssisted---XhimigEants," made . by the Pe.p%f.(ment ^llowing consulfatiohs be-, tween the director of the tuberculosis division and medical staff of the Ministry of Health, iuet with the approval of the iramigration branch of the Department of Employment and Labour, " stated the Director-General. "However, advice recently received by that office from the. Highr Commissioner 's office, indieates that since then the uational health service has come into operation and that this has, for various reasons, made .^cibsolete the whole of the proposals disCussed at' that time. The matter is being thoroughly examined by the Ministry of Health whicb is seeing what assistance can be giveri in the X-raying of prospeetive assisted immigrants."