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April 8, 1968

Epidemiology of Tuberculosis

JAMA. 1968;204(2):177. doi:10.1001/jama.1968.03140150081033

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To the Editor:—  I have read with interest Dr. Stead's views on the pathogenesis of tuberculosis in tuberculin-positive persons. The experience on the USS Boston presented in The Journal supports the long-held impression that a prior infection manifested by a positive tuberculin skin test provides considerable protection for those who are heavily exposed.In the group of 532 men studied in detail, 76 men (14.3%) were tuberculin-positive prior to the discovery of the first case of active disease aboard ship, and 209 men of the remaining 456 were tuberculinnegative and converted. Only two of the 76 of the men who were initially positive (2.6%) developed cli ical signs of active disease, while 16 of the 209 converters who were initially negative (7.7%) developed active pulmonary tuberculosis. By comparing similar groups of tuberculin-negative and tuberculin-positive, healthy, young adult men, subjected to the same heavy exposure in a closed environment, it appears