Læknablaðið - 01.02.1976, Side 83

LÆKNABLAÐIÐ
47
tuberculin tests and positive avian cultures)
found in cattle may perhaps also be of human
origin although not stated.
Mention is made of the fact that myco-
bacteria other than mycobacterium tuberculosis
have been noted during the tuberculin testing
in the country. This is a rare and local pheno-
menon which happens mostly in the neighbour-
hood of warm swimming pools. Mycobacterium
balnei was considered to be the agent.
The medical profession of the country is
urged to remain alert to the disease even if
it is becoming rare. Tuberculin testing should
be used widely, especially among children and
young adults. Since Iceland has mostly re-
frained from BCG vaccination the positive
tuberculin reaction has come to be of great
diagnostic value. Thorough instruction must be
given to those concerned with the tuberculin
testing procedure and its interpretation. It is
also of great importance in the tuberculin
negative community to track down the open
case as soon as possible. Such a patient must
receive adequate treatment and be kept in
isolation as long as he remains contagious.
Careful follow up is necessary in all such
cases as well as those freshly infected persons
who may have received secondary chemo-
prophylaxis.
BCG vaccination should be offered to groups
such as medical students, student nurses and
children and young adults living with people
who have had tuberculosis.
Use of secondary chemoprophylaxis is in
many cases advisable but primary chemo-
prophylaxis should only be used when there
is very strong suspicion of infection in spite
of negative results of repeated and adequately
performed tuberculin testing.
The possibility of complete eradication of
the disease from the country is discussed. The
unusually rapid decline in the tuberculosis in-
fection rate, morbidity and mortality during
the last decades are tempting facts for such
thoughts. In order for such an eradication to
take place transmission of tuberculosis from
open cases must be prevented to the utmost in
order to constantly reduce the infection rate
and thereby the number of carriers. Further-
more immunological factors and living condi-
tions are of great importance in the community
concerned.
Tuberculosis is still a great problem in many
countries. With ever growing intemational
communications complete eradication of tuber-
culosis is a worldwide project and can hardly
be achieved by any single country. Thus era-
dication is not likely to be achieved in the
near future although it should be constantly
strived for.
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