-- ATTENTION --
DO NOT routinely administer antibiotics on the assumption
that streptococci cause most sore throats.
3-13. BACTERIAL INFECTIONS: TUBERCULOSIS
Tuberculosis is a chronic disease of variable course that is present in nearly every
community, including the military community as a whole. It is an important cause of
death in most parts of the world.
a. In Military History. In the US Army during World War II, tuberculosis
incidence rates were approximately one per 1,000.
b. Transmission. The disease is transmitted by droplets, droplet nuclei, direct
contact with an infectious person, and by ingesting milk from infected cows.
Tuberculosis is caused by Mycobacterium tuberculosis, the tubercle bacillus.
c. Signs/Symptoms. The primary or initial infection is likely to go unnoticed.
Tubercular lesions of the lungs develop and heal without treatment. The infected
person is infective during periods when lesions are open and discharging bacilli, but
noninfective when all lesions are healed over in remission. The respiratory discharges
and sputum of many infected persons remain intermittently for years.
d. Treatment. Although most primary lesions heal without treatment, prompt
therapy of active cases with anti-tubercular drugs is indicated, provided the patient can
tolerate the regimen and drug-fastness does not develop.
e. Control Measures
"Open" tuberculosis cases should be hospital isolated, initially at bed rest,
until lesions heal and the patient has learned the hygienic essentials of tuberculosis
Periodic x-ray examination of the lungs and tuberculin test surveys of the
general population (and more frequently for those at special risk, such as Army Medical
Department personnel,) uncover recent primary infections.
All personnel entering the U.S. Army is skin tested initially. Negative
reactors should be skin tested annually.
Positive reactors who do not receive antibiotic prophylaxis should have
annual chest x-rays.