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October 21, 1983

Tuberculin Conversion in Indochinese Refugees

Author Affiliations

Stanford University Medical Center Stanford, Calif

JAMA. 1983;250(15):1978. doi:10.1001/jama.1983.03340150022017

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To the Editor.—  The article by Morse et al (1982;248:2983) concerning the high rate of tuberculin conversion in Indochinese refugees describes an alarming rate of conversion reactions over six months in our largest refugee group. Notable by its absence was any reference to the problem of faulty Aplisol (tuberculin). This PPD preparation has been implicated by the Centers for Disease Control (CDC) in a letter published Sept 23, 1982, stating that, "based on the best information available to CDC and FDA [Food and Drug Administration] all lots of Aplisol released since September 1980 may have been associated with increased reactivity." According to a CDC memorandum dating from July 13, 1982, 92% of those persons thought to have a positive PPD when Aplisol was used had a negative PPD when retested with Tubersol (tuberculin). Furthermore, all Aplisol until a few months ago was prepared from the same master batch dating from