Significant primary pulmonary tuberculosis in young contacts

A review has been made of 154 children admitted to hospital with a contact history; their age distribution and the pathological lesion on initial X-ray have been given. All these contact children had an abnormality in their original chest X-ray.

Mothers and fathers were the most important source cases of their children's infection. Practically all the source cases had positive sputum on direct examination. Contacts were considered to have been exposed to an infectious source case for at least five months.

It is suggested that there should be an energetic search for contacts of an active case of pulmonary tuberculosis, and BCG offered to tuberculin negative children. Tuberculin positive children under puberty should have an initial X-ray and another within three months. In the absence of any significant pulmonary abnormality, no further X-raying would be required, especially if the source cases' sputum examinations were negative for tubercle bacilli or positive only on culture.

Children in the age group 10–15 run a special risk of the development of post-primary pulmonary tuberculosis, and should continue to be seen at regular intervals.