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Protection of children from tuberculosis
194
TUBERCLE
Protection of Children from Tuberculosis T h e following letter has been sent fi'om the Ministry of Health to all Local Health Authorities in England: I am directed b y the Minister of Health to state, that certain recommendations have been made to him by the Joint Tuberculosis Council regarding the protection of organized groups of children against the risk of infection by adults suffering from tuberculosis. These recommendations are to the following effect: (I) No person with respirator 3" tuberculosis should be engaged for emplo)wnent which involves close contact with groups of children unless and until the disease is certified as arrcstcd. A candidate for such employment should therefore not be engaged without a medical exami.nation, including an x-ray examination of the chest. (2) Persons whose employment brings them into close contact with groups of children should have an x-ray examinatioh of the chest annually. (3) I f a person while thus employed is found to be suffering from respiratory tuberculosis, such employment should at once cease, and not be resumed until two consecutive medical certificates are given, the first stating that the disease is no longer active, and the second (after a filrther interval of six montlrs) stating that the improvement in the general and local condition has been m_aintained, both certificates being based on x-ray and bacteriological, as well as clinical, investigation. After resumption of employment similar investigations should be carried out at three-monthly intervals for the first }'ear and at six-monthly intervals for the next two years. (4.) I f an}, unusually high incidence of respn'atory or non-respiratory tuberculosis occurs in an organized group of children a fidl investigation of the staff employed should at once be undertaken. The Minister agrees with these recommendations, and ill view of his general responsibility for the public health and his particular concern in measures to combat tuberculosis, is anxious that everything possible shall be done to give effect to them. He asks the Council accordingly to do all they cart to have the recommended measures carried out for the protection of groups of children under their care in their capacity as local health :tuthority, including children in day nurseries provided under section 22 of the National t-Iealth Service Act, 1946.
August 1950
It is not expected that local health authorities will have difficulty in carrying out the first and third recommendations the principle of which was embodied, so far as nurseries are concerned, in the Minister's Circular I Ix/44 issued on August 30, i944. The Council m a y not find it easy to put into fidl effect the second recommendation, with regard to group x-ray examination of the staffs concerned, in view "of the numbers of pcrsons concerned and the pressure on x-ray'l~lcilitics; but the Minister is anxious~ that" attthorities should do their best to make Comprehensive arrangements. T h e x-ray examinations might be made at hospitals or chest clinics, or through a mass radiography unit, and authorities should consult Regional Hospital Boards as to ways and means of arranging for these examinations. Where arrangements are made for individual examinations at hospitals or chest clinics fees will be payable by the Council (except in the cases arising under (4) a b o v e - e x a m i n a t i o n of contacts) but the cost of these will rank for I~xchequer grant as expenditure in connexion with tile prevention of tuberculosis under Section o-.8 of the National Health Service Act. A copy of this Circular is enclosed for the information of the Chief Financial Officer of tile authority and a copy has been sent sei~arately to the Medical Officer of Health.
Correspondence "Whither Tuberculosis ?
"
The E d i t o r - 'Tubercle'. S m , - - I think most senior members of the Public Health Service will agree with the admirable letter of I)r Lissant Cox ill your issue for J u n e I95O , but as he refers to the Welsh National Memorial Associatign , I am a little surprised that he should not mention in the 5th of his proposed remedies on the appointment of Professors, that we in the Welsh Nktional School of Medicine, have had for twenty-nine years a David Davies Professor of Tuberculosis, concerned amongst other things ~'ith the award of the T.D.D. (Tuberculosis Diseases Diploma) which is probably known all over the world. I am yours, etc.,
Public Health Department, J. GREENWOODWILsox. City llall, Cardiff.
TUBERCLE
Protection of Children from Tuberculosis T h e following letter has been sent fi'om the Ministry of Health to all Local Health Authorities in England: I am directed b y the Minister of Health to state, that certain recommendations have been made to him by the Joint Tuberculosis Council regarding the protection of organized groups of children against the risk of infection by adults suffering from tuberculosis. These recommendations are to the following effect: (I) No person with respirator 3" tuberculosis should be engaged for emplo)wnent which involves close contact with groups of children unless and until the disease is certified as arrcstcd. A candidate for such employment should therefore not be engaged without a medical exami.nation, including an x-ray examination of the chest. (2) Persons whose employment brings them into close contact with groups of children should have an x-ray examinatioh of the chest annually. (3) I f a person while thus employed is found to be suffering from respiratory tuberculosis, such employment should at once cease, and not be resumed until two consecutive medical certificates are given, the first stating that the disease is no longer active, and the second (after a filrther interval of six montlrs) stating that the improvement in the general and local condition has been m_aintained, both certificates being based on x-ray and bacteriological, as well as clinical, investigation. After resumption of employment similar investigations should be carried out at three-monthly intervals for the first }'ear and at six-monthly intervals for the next two years. (4.) I f an}, unusually high incidence of respn'atory or non-respiratory tuberculosis occurs in an organized group of children a fidl investigation of the staff employed should at once be undertaken. The Minister agrees with these recommendations, and ill view of his general responsibility for the public health and his particular concern in measures to combat tuberculosis, is anxious that everything possible shall be done to give effect to them. He asks the Council accordingly to do all they cart to have the recommended measures carried out for the protection of groups of children under their care in their capacity as local health :tuthority, including children in day nurseries provided under section 22 of the National t-Iealth Service Act, 1946.
August 1950
It is not expected that local health authorities will have difficulty in carrying out the first and third recommendations the principle of which was embodied, so far as nurseries are concerned, in the Minister's Circular I Ix/44 issued on August 30, i944. The Council m a y not find it easy to put into fidl effect the second recommendation, with regard to group x-ray examination of the staffs concerned, in view "of the numbers of pcrsons concerned and the pressure on x-ray'l~lcilitics; but the Minister is anxious~ that" attthorities should do their best to make Comprehensive arrangements. T h e x-ray examinations might be made at hospitals or chest clinics, or through a mass radiography unit, and authorities should consult Regional Hospital Boards as to ways and means of arranging for these examinations. Where arrangements are made for individual examinations at hospitals or chest clinics fees will be payable by the Council (except in the cases arising under (4) a b o v e - e x a m i n a t i o n of contacts) but the cost of these will rank for I~xchequer grant as expenditure in connexion with tile prevention of tuberculosis under Section o-.8 of the National Health Service Act. A copy of this Circular is enclosed for the information of the Chief Financial Officer of tile authority and a copy has been sent sei~arately to the Medical Officer of Health.
Correspondence "Whither Tuberculosis ?
"
The E d i t o r - 'Tubercle'. S m , - - I think most senior members of the Public Health Service will agree with the admirable letter of I)r Lissant Cox ill your issue for J u n e I95O , but as he refers to the Welsh National Memorial Associatign , I am a little surprised that he should not mention in the 5th of his proposed remedies on the appointment of Professors, that we in the Welsh Nktional School of Medicine, have had for twenty-nine years a David Davies Professor of Tuberculosis, concerned amongst other things ~'ith the award of the T.D.D. (Tuberculosis Diseases Diploma) which is probably known all over the world. I am yours, etc.,
Public Health Department, J. GREENWOODWILsox. City llall, Cardiff.