| Popis: |
Present basic principles of tuberculosis control consist of (1) prevention of inter-human infection, (2) sterilization of the bacillary reservoir in the population, and (3) development of methods of prophylaxis. Historical changes in this century have brought us first through an era of basis hygiene, then one of specific therapy, and now, to the beginning of an era of prevention and prophylaxis for the future. Because of bacteriologic seeding already present among the living, concepts of eradication of tuberculosis at present probably must be thought of in terms of the next three generations, approaching a century in time. To start, maximum effort now for maximum achievable results with present methods will require (1) locating and treating all active cases, (2) monitoring all old cases and high risk groups, and (3) detecting all tuberculin reactors as a foundation for follow-up programs and prophylaxis when indicated. The role of every physician whatever his field is of paramount importance in such a program. Three critical times in the life cycle of each generation for tuberculosis where universal tuberculin testing is needed are (1) the child in school, (2) the young adult as a pre-marital requirement, and (3) the grandparent at retirement as a social security requirement. Basic tools needed for eradication but still lacking are (1) a universally effective vaccine, (2) an accurate serologic test for tuberculosis, and (3) a rapid-acting bacteriocidal therapeutic agent. Re-examination of our national research program in an effort to fulfill these needs is warranted now. In addition, changing social patterns in the United States today require development of new methods for reaching, educating, and motivating people if the future program for tuberculosis is to be carried to where the disease is. Eradication of tuberculosis as a national goal is a bold and worthy concept for which preparation should logically begin now, so that it may become achievable that much sooner in the future. |
