Tuberculin testing of the aged.

The advent of antimicrobial drugs has brought the significance of the tuberculin test in sharp focus. This test determines the magnitude of the tuberculosis problem in groups of people since it readily detects those who are harboring tubercle bacilli. Evidence is accumulating which suggests that the clinical tuberculosis of the future will occur largely in those now infected. Only the tuberculin test finds who is infected. Statistics indicate that surviving members of the older generation are now contributing a preponderance of the deaths from tuberculosis annually. A great deal of tuberculin testing has been done and is being done among school children. The incidence of infection among those in our elementary schools has definitely decreased. Twenty years ago the percentage of reactors in our high schools was about 35 per cent. Today it is 10 to 15 per cent. Among people of 60 years and over, little tuberculin testing has been done. No concentrated effort has been made to determine what percentage of them is infected. On May 28, 1956, we tested 2,104 people of 60 years and over, in the Cook County Institutions, at Oak Forest, Illinois. The success of this project was made possible by the cooperation and participation of the medical and nursing staffs of the Institutions and the Tuberculosis Institute of Chicago and Cook County. The intradermah method of Mantoux was employed, using 0.1 mg. of old tuberculin. Tests were read 48 hours hater and extent of reactions was not recorded. More than two-thirds (67.5 per cent) of the hospital infirmary population were men (Tables I and II). More than 90 per cent were white. One-half of those participating (1,040) were from 70 to 89 years old. Another 40 per cent were 50 to 69 years old. Thus 90 per cent were between 50 and 90 years of age. The oldest individual was 114 years. Of the 1,606 reactors, 71 per cent were men of whom 90 pen cent were 50 to 59 years of age. About 76 per cent of the total tested were reactors. The study included 1,420 men of whom 80 pen cent were reactors. Of the 684 women tested 69 per cent reacted. Seventy-five per cent of the white population and 86 pen cent of nonwhite groups were positive. The percentage of reactors (81.5) was highest for those of 50 to 69 years. About 74 pen cent of those between 70 and 89 years reacted. Of the 45 over 90 years, 53.3 pen cent reacted.