Tuberculosis in Edinburgh: B.C.G. Vaccination and Heaf Tuberculin Grades at School

Abstract

Some recent findings, in respect of tuberculosis in Edinburgh, are presented and particular attention is given to the younger members of the population. It is recognised that Heaf grade I tuberculin reactors at school may not all have been infected by tubercle bacilli, and it has been thought that some might benefit from B.C.G. vaccination. The evidence given confirms the value of B.C.G. vaccination in the prevention of tuberculous disease in the community. Some Heaf grade I reactors have tuberculous disease, however, which is a contraindication to routine vaccination of this group. Another contraindication is that Heaf grade I reactors, as a whole, have acquired a degree of immunity to subsequent tuberculous disease, approximating that conferred on tuberculin negative children by B.C.G. vaccination, and possibly less likely to diminish as the years progress. Widening the scope of B.C.G. vaccination and employment of anti-tuberculosis drugs, might be advantageous and merits consideration.