SCREENING OF TB CONTACTS BY
TUBERCULIN SKIN TESTS IN
A LOW-INCIDENCE COMMUNITY PROTECTED
BY BCG VACCINATION
Trnka L. 1 , Daňková D. 1 , Krejbich F. 1 , Švandová E. 2 , Krenarová J. 3 , Spilka J.
National Unit of TB Control, Clinic of Pneumology and Thoracic Surgery, Faculty Hospital Bulovka, Prague |
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Summary:
A 36-year-old man, an unemployed waiter, a regular patron of two bars living in a Czech city suffered for about a year from disorders caused
probably by tuberculosis (TB). When hospitalised, diabetes mellitus and extensive lung TB were diagnosed. TB was found also at the post mortem
examination when the patient died one week later. Screening of his contacts by tuberculin s kin tests (2TU RT 23 W.Tw.80) provided data for analyzing
the usefulness of tuberculin tests for monitoring of propagation of TB infection among BC G vaccinated population with high TB prevalence in the
past.
A statistically significant difference was found in tuberculin reactivity between 543 contacts and 232 individuals who had not reported contact with
the patient. A skin reaction of 12 mm and more was found in 55.6 % contacts while only in 2.6 % of those included in the second group.
The high tuberculin reactivity was proved in the individuals exposed to massive TB infe ction. Neither BCG vaccination, nor possible previous
contact with TB in the past seemed to influence the actual tuberculin reactivity in the group of non-contacts. Furthermore, it is indicative of the fact
that unknown TB sources are rare among the Czech population. The high tuberculin reactivity is suggestive of a fresh infection and justifies the
tuberculin testing and the application of chemoprophylaxis.
Key words:
contact with tuberculosis, tuberculous infection, tuberculin test, BCG vaccinated population
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