Tuberculosis Control in Schools

¹ Superintendent and Medical Director, Riverside Sanatorium
² Granite Falls, Minnesota

1. This report concerns a study of tuberculosis in schools in a four-county sanatorium district which has been in continuous operation since 1930.

2. The program has consisted of administering the tuberculin test to children and personnel with roentgenographic inspection of the chests of the reactors, and complete examination of those with shadow-casting lesions suspected of being tuberculous.

3. For each tuberculin reactor a careful search has been made for the source of the infection among adult associates.

4. A serious tuberculosis problem was found and solved among teachers and other school employees.

5. When children and personnel members have presented progressive clinical pulmonary tuberculosis, they have been promptly removed from the schools. Outside sources of infection, when found, have also been isolated in a sanatorium as soon as possible.

6. The Certification of Schools Project of the American School Health Association was adopted in 1946. This required testing with tuberculin 100 per cent of personnel and 95 per cent or more of children from kindergarten through the 12th grade. All schools in the four-county area soon qualified for certification and have since maintained this status.

7. Among the more than 150,000 children studied over the years, locating sources of exposure, isolating and treating them and carrying out the remainder of the original aims, the tuberculosis morbidity rate has been reduced from 83.1 per 100,000, average age 25 years, in 1930 to 7.7 per 100,000 age 65 to 70 years in 1965. The mortality rate in 1930 was 26.1, but in 1965 none died. More than 15 per cent of school children reacted to tuberculin in 1930, but only 2.2 per cent in 1965-66. Testing of the cattle of this district in 1966 revealed only one tuberculin reactor.