Tuberculosis Among Sanatorium Personnel

¹ Medical Director, Tuberculosis Sanatorium of the Ministry of Public Health and Assistance, Hulpulco, Mexico, D. F.

Only four infiltrates thought to be tuberculous, one of which was open tuberculosis, were discovered among 357 highly exposed people during eight years.

The results of our experience confirm our belief that the measures adopted before the opening of the Sanatorium were justified. Therefore we believe that the main factors for protection against reinfections among personnel are:

1) Evidence of an old lesion, the older the better, as demonstrable by the residual roentgen appearance.

2) The lesion must be apparently extinguished but the tuberculin test ought to remain positive.

3) The personnel must be selected among people over twenty years old. This measure makes, at least in Mexico, more possible an old infection to be completely inactive.

4) All exposed people must have well balanced diet, limited number of working hours, and should be instructed to protect themselves against infection.

5) The sanatorium must be built so as to allow many hours of exposure to the sun so as to afford the effect of the ultraviolet rays on contaminated surfaces.

If these rules are followed, it is possible to obtain results such as ours, which seem rather paradoxical, as the workers at the tuberculosis sanatorium become reinfected less frequently than the population in the City of Mexico, where the expected morbidity is 1.3 per hundred, while it is zero in our nurses group and under 1 in the highly exposed people. The educational standards, habits, hygienic way of living and diet are very much lower than the American level among our personnel, excepting physicians.