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January 5, 1979

The Epidemiology of Tuberculosis in Physicians

Author Affiliations

From the Department of Community Medicine, University of California, San Diego.

JAMA. 1979;241(1):33-38. doi:10.1001/jama.1979.03290270023014

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 medical school decreased by 78%. Tuberculin conversion rates among 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-Guérin vaccine recipients had 80% less tuberculosis than unimmunized physicians infected after beginning medical school.

(JAMA 241:33-38, 1979)