The epidemiology of tuberculosis in physicians
E. Barrett-Connor
The incidence of tuberculosis in physicians was determined by mailed
questionnaire. Since 1950 tuberculosis infection preceding entry into
medical school has decreased by 73%; at the same time, infection after
beginning recent graduates exceeded 1% per year, and age-specific infection
rates among physicians were at least twice the US average. Tuberculosis
developed in nearly one in ten physicians infected after medical school
entry; in two thirds, disease preceded or coincided with recognized
tuberculin positivity. No tuberculosis occurred in physicians who used
isoniazid chemoprophylaxis, but two thirds of tuberculin-negative
physicians did not have annual skin tests, 56% of known recent converters
used no chemoprophylaxis, and 25% of those initiating isoniazid prophylaxis
did not complete a 12-month course. The Bacillus Calmette-Guerin vaccine
recipients had 80% less tuberculosis than unimmunized physicians infected
after beginning medical school.
