Historical October 1977 People’s Clinic report. Original descriptions of tuberculosis testing and treatment are preserved as archival material, not current clinical guidance.
Epidemiology is the study of disease patterns in a community. It is performed on a large scale by health agencies. They keep track of how often a particular disease occurs, and how many people recover or die from it. One of their more important activities is to trace communicable diseases to their source and to follow the possible spread of known cases. By doing these last two things, they can contact the people involved and recommend treatment. In this way a potential epidemic can be stopped. Tuberculosis is one of the communicable diseases that they keep track of.
TB is still very prevalent even in this country. True, its incidence is much lower that it was just a few decades ago, but it is far from wiped out. Epidemiology is very important in the battle against this disease for two reasons. First, it’s highly contagious. Secondly, it can be fatal if left untreated, but the cure rate with early treatment is extremely good.
The national health agencies’ records show that St. Louis has a relatively high incidence of TB. Looking at the City Health Department records we find further localization in the central strip of the city heading west from downtown. The next level of records tell of individual cases.
The People’s Clinic was involved in a case recently with some of our members. A family in our neighborhood had had contact with someone who had active TB. One of the children who was feeling bad came in to the clinic for a check up and a TB skin test Anyone can get this simple test. A positive reaction to the test does not mean that one necessarily has the disease, but only that he has had contact with the germ. He may or may not have successfully fought off the infection.
So follow up tests like chest x-rays are used if there’s a positive reaction.
In the case at the clinic the first skin test was negative. However the boy continued to feel poor. A general ill feeling can be a symptom since TB is an infection. Often though, the disease shows no outward signs until very late. He returned to the clinic for a second test which had very positive results. This reaction pattern is not unusual because the TB germ has a 3 to 10 week incubation period before an active infection begins. So a second test is a good idea if you’ve had definite contact.
As I said before, a positive skin test is always reason for follow up. It is especially significant when the reaction was recently negative and there has been contact. The patient was referred to Barnes Hospital where he was admitted for treatment. Then the rest of the family were called to come in to the clinic for skin tests. They have all had negative results so far. The patient has returned home. He and his family were treated with antituberculosis medication from the health department.
So here we have an epidemiological success story: A serious contagious disease was found in its early stages due to a family’s conscientious health practices. They checked into unusual signs and followed up when minor poor health did not go away.
The People’s Clinic, their primary health care facility, then proceeded to coordinate the necessary action. First they referred the patient to the hospital. In doing so, further spread of the disease was stopped. They contacted the most probable contacts, the family. And finally, the public health agency was notified so they could follow through.
Originally published in The Paper, October 1977.
Read this article in the original newspaper issue.
Archival transcription note: The printed ‘lower that’ and the missing punctuation before ‘Anyone’ are retained.
Original source: SD_Times1977_10.pdf, printed page(s) 7; PDF page(s) 7.
