TAILIEUCHUNG - Untreated Inactive Pulmonary Tuberculosis

Although the foregoing studies have indi¬ cated considerable variation in the average an¬ nual reactivation rate, a variation that could be related both to differences in the definitions of a case and in the living conditions of the study populations, all agreed that the risk of reactivation was substantial. And yet there is surprising variation in the period of observa¬ tion recommended for persons with inactive pulmonary tuberculosis. Some health depart¬ ments do not advise any followup of persons with newly diagnosed minimal inactive disease; others advise periodic examinations for 5 years or longer. Such variation in public health practice suggested the need for further infor¬ mation on the importance of relapses among persons with inactive. | Untreated Inactive Pulmonary Tuberculosis Risk of Reactivation GEORGE w. COMSTOCK . . The relapsing tendency of pulmonary tuberculosis is widely known and well documented. In 1938 Puffer Stewart and Gass I reported from the Williamson County Tenn. Tuberculosis Study that 12 percent of white persons classified as having minimal arrested tuberculosis and 15 percent of those having latent apical tuberculosis had become worse during a 3-year period of observation. Reisner and Downes investigated the relapse rate among a sample of persons with productive fibrotic or calcific minimal tuberculosis who attended the ambulatory chest clinics of the New York City Department of Health. They found 5 percent of whites and 14 percent of nonwhites had developed active disease in 5 years. Among a group of upstate New York patients diagnosed by the staff of Hermann M. Biggs Memorial Hospital between 1937 and 1947 as having minimal arrested tuberculosis the risk of developing active tuberculosis during the 10 years following diagnosis was 13 percent . Similar studies have been made in other countries. Kallquist 4 reporting from Sweden on the experience of 312 persons considered to have inactive or probably inactive tuberculosis noted that 8 percent had shown evidence of active disease within a period of 8 years. A comprehensive report on the Danish Tuberculosis Index by Groth-Petersen Knudsen and Dr. Comstock is with the Tuberculosis Branch of the Communicable Disease Center Public Health Service Washington . Wilbek 5 included observations on 560 persons never previously reported as tuberculosis cases because their chest roentgenograms were considered to show fibrosis only. Within 4 years nearly 2 percent had developed active disease. In south India Frimodt-M011er Ổ found an average annual reactivation rate of 6 percent for persons classified as probably having inactive tuberculosis and 1 percent for those initially considered to have clinically insignificant inactive .

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