AN OUTBREAK OF PRIMARY TUBERCULOSIS IN SCHOOL CHILDREN - CLINICAL ASPECTS

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Abstract
Based on experience in an outbreak of primary tuberculosis among school children, it is concluded that, for greatest yield with the least expenditure of time, money, and personnel, a survey is best conducted 3 months after detection of the original case. The value of routine posteroanterior and lateral roentgenographic projections in at least the first examination is well demonstrated and may serve to explain why so high a percentage of the "exposed group" were found to have clinical evidence of tuberculosis. Serial bimonthly roentgenograms for not less than 6 months from the date of diagnosis of the original case will give a truer picture of incidence of pulmonary disease than the more generally accepted practice of semiannual or annual roentgenographic examination, as the initial pulmonary lesions may be evanescent. Early therapy seems to have been well justified, as evidenced by almost complete clearing of all disease in all of the patients at the end of the 18 month point of observation. Early therapy may have prevented caseation necrosis of the mediastinal lymph nodes, since so few of the patients have as yet demonstrated calcification of the nodes or of the primary complex. Present techniques for control of tuberculosis seem adequate and re-emphasize the value of early detection, isolation, and treatment. The results further suggest that the public can be reassured that facilities already set up and constantly functioning should be able to prevent an epidemic spread of clinical tuberculosis. At the same time, the size of the problem demonstrated by this investigation emphasizes the importance of eternal vigilance.

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