Tuberculosis Studies in Muscogee County, Georgia

PROTECTION of the uninfected was a major concern of the Tuberculosis Control Program of the Public Health Service in 1950. The belief that most tuberculosis in this country was coming from persons who had recently been infected was then still generally accepted, and the time-honored method for control was to attempt to find and isolate the person with an infectious case as early as possible in the course of his disease. This method was like locking the barn after the horse has been stolen. Although it was better to isolate the infectious person then rather than never, many contacts had often already become infected by the time the index case was diagnosed. A preventive measure, such as active immunization, that conferred protection before exposure had obvious appeal. Other communicable diseases had been brought under control when active immunization supplanted casefinding and isolation of patients. Support for active immunization as a method of preventing tuberculosis was brought to a focus in the United States by the mass BCG vaccination campaigns being conducted at this time by the World Health Organization in many warravaged countries. If BCG vaccination proved as effective as its proponents claimed, it might be the ideal lock for the barn door. Because it seemed prudent to test BCG before embarking on a mass campaign in this country, the Public Health Service undertook a series of systematic studies,