Tuberculin patch test (Vollmer) on B C G vaccinated and control children

Abstract

A NUMBER of studies have been published recently on a tuberculin patch test as described by Vo]lmer. ~ These studies have been concerned, for the most part, with a comparison between the patch and intradermal methods of administering tuberculin to children of a known tuberculous process, active or inactive. It is agreed generally that such processes are associated with a degree of tuberculin activity usually higher than that following B C G vaccination. Consequently a comparative study in B C G vaccinated children seemed to offer a reasonably crucial trial of the efficiency of the patch test. The children concerned in the present study, half of whom were vaccinated with B C G at 4 to 7 days of age, ~ have been followed from birth by semiannual clinic visits. The immediate members of the family were examined roentgenologieally by chest plate before the birth of ~the child. The subjects of this report were a]l delivered at Cook County Hospital and consequently came from more or less the same economic strata, the race distribution being approximately 63 per cent colored and 37 per cent white. The immediate family environment was nontuberculous. However, the general milieu of the great majority of the children shows a high incidence of tuberculosis based upon the recently reported morbidity and mortality statistics indicated by census districts of the city of Chicago2 The follow-up studies of these children included among other things semiannual tuberculin tests. These are, of course, necessary for the determination of infection among the control children on the one hand and to estimate the duration of the allergic response of the vaccinated children on the other. Statistics concerning this particular phase of the problem are being published elsewhere. 2 The routine established was to perform a Mantoux test on the right forearm using 0.1 c.c. of old tuberculin in concentration varying from 1:1,000 to 1:100. At the same time a patch test was applied to the interscapular region in the horizontal plane. The Mantoux tests were read in forty-eight hours and the patches removed. Two days later, or ninety-six hours from the time of application, the children were again seen and the patch test read. In Table I are summarized the results of this study. Comparisons were made between the patch test and Mantoux test done with different dilutions of old tuberculin. The dilution of tuberculin was determined