Preventive treatment of tuberculin-negative contacts

Five children who had been in close contact with highly infectious tuberculous individuals presented recently to the tuberculosis service of The Montreal Children's Hospital. Four had developed serious pulmonary tuberculosis and one tuberculous meningitis, all within the three months which followed a post-contact negative tuberculin test.The management of tuberculin-negative children recently exposed to active infectious tuberculosis by repeated skin tests and chest radiography alone is inadequate for their protection. These children are at high risk of developing disease by the time their tuberculin sensitivity has become evident. It is inadvisable to vaccinate them with BCG until three months after their last exposure to the disease. A plea is made for preventive chemotherapy in these cases.