Epidemiology of tuberculosis in Greenland.
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Biomedical subjects
Publications and source records attributed to O Horwitz.
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A study was made of the responses of schoolchildren to tuberculin testing 2 months and 5 years after vaccination with one of 11 different BCG vaccines prepared by several laboratories from different strains. The fact that the allergenic response was almost unchanged after 5 years shows that a long-term follow-up adds nothing of any significance to the information obtained 2 months after vaccination. The study also showed that postvaccinal tuberculin testing is only of value in determining the level of the allergy in groups of persons. It yields little information on the level in individuals since several factors, including unavoidable experimental errors and unknown personal factors, greatly influence the reaction.
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The introduction of chemotherapy dramatically changed the epidemiology of tuberculosis as the risk of infection was thereby nearly eliminated. The present paper illustrates the risk of disease under these conditions. A large and representative segment of the Danish population, a total of over 626 000 persons aged 15-44 years, was examined by a standardized technique in 1950-52 and has now been followed for 12 years. It has been possible by means of simple parameters such as infection and vaccination status, X-ray lesion and age to divide the population into groups with widely different incidence rates. The time trend in disease rates among vaccinated persons and natural reactors suggests that post-primary tuberculosis is of great significance in the present tuberculosis situation. Three-quarters of all cases stem from the natural reactors. It would have been of great practical significance to identify high-risk groups which yielded a great part of the patients. This was not possible since the majority of cases developed among reactors whose distinctive feature was that they were infected at time of examination.
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