TUBERCULOSIS —a Changing Scene

New Zealand Listener, Volume 32, Issue 822, 29 April 1955, Page 22

TUBERCULOSIS —a Changing Scene

POPP PPB POPP This is the text of a talk on health

given recently from ZB, YA and YZ

stations of the NZBS by DR.

H. B.

TURBOTT

Deputy-Director-General

of Health

‘| HERE have been some great changes going on regarding tuberculosis in our land. More unsuspected sufferers are being discovered. Mass radiology is helping in this. Prior to the use of mass X-rays the X-ray eye did not range outside our hospitals or the rooms of private radiologists. Now it is constantly widening its detective range and finding unsuspected cases. Another procedure that helps to discover hidden infections is the tuberculin testing that is going on preliminary to B.C.G. vaccinations. The negative reactors, of course, take the

B.C.G. vaccination as a protection{ against infection. , The positive reac-; tors have already. had their infection with tuberculosis germs and require further investigation through chest Xrays to see whether

any disease has followed that infection. While most of these X-rays of positive reactors to the tuberculin test are clear, an occasional unsuspected and new case is revealed. While more unsuspected su#erers are being found, we are not getting more new cases. This is because of the dramatic arrest of infectivity in new cases and in old ones, from modern treatments. Drugs such as para-amino-salicyclic acid -PAS for short-streptomycin, isonicotinic acid hydrazide, singly or in combinations, with or without modern surgical procedures, have changed the picture. While not successful universally, these new treatments have turned infective folk to harmless recoveries, and speeded up cures in enough sufferers to decrease the death rate and keep new infections down. So much so that in our country Sanatorium beds are being closed and a new sanatorium planned does not now need to be built. The tuberculin testing being done confirms this great improvement in another way. Fewer adolescents throw’ a positive reaction nowadays than. that age group did in the twenties and thirties of this century. This means there is less infection about in the community. More sufferers are being detected and returned to the community healed over, non-infective to others, and able to earn their livelihood again. No longer need there be the old fear of tuberculosis. More than ever before it can be cured. In six years there has been a reduction of fifty per cent in| tuberculosis deaths. Nurses in hospitals used to be paiticularly at risk. For some years close attention has been paid to their health, They have been tuberculin tested, X-rayed if a positive reactor, and, if a negative reactor protected against infection by B.C.G. vaccination. In six years of this type of surveillance, there has" been a steady fall in the number of. cases of tuberculosis in nurses, until it is now down to one-fifth of what it used to be. This type of attack on tuberculosis, detecting more cases through tuberculin | testing and X-rays, or through mass X-rays, curing more cases through combinations of modern treatments, will go.

on being successful, the more so as you all understand it, and respond to it by consenting to the procedures should your section of the community be asked to do so. All this work is aimed at pulmonary tuberculosis, for it is continued’ exposure to infection, from known or hidden cases, that causes trouble from this disease. Only a small proportion of tuberculosis is caught from infected milk. Here again, is a success story. As the amount of pasteurised milk in the community has risen, the infection from bovine source has fallen. We have less enlarged neck glands; less abdominal and bone tuberculosis and less meningitis arising from tuberculous milk. However, some people will not believe in this safeguard and go on using raw milk. ; In one of our rural towns the tuberculin test in adolescents showed 43 per cent positive reactors -that is, 43 in each hundred had been infected with tuberculosis germs: Now in our country as a whole the usual result is from 10 to 20 reactors in éaciy hundred. The unusually high response in the rural town led to an inquiry. The town was drinking unpasteurised milk. A couple of. the herds supplying the town showed tubercle bacilli in the milk, and the culls from. the herds after tuberculin testing showed tuberculous lesions at post mortem, ; Don’t let this lesser avenue of tuberculous infection continue. If you can’t get pasteurised milk, either home pasteurise or boil your milk; and be. safe from bovine infections. 2 > xy