USE THE PPD EVEN IN BCG VACCINEES.

Although BCG vaccine is not used in the United States, physicians here must often decide how to interpret a positive tuberculin skin test in foreign-born patients. This study examined PPD responses in 783 children (aged 3 months to 5 years) in Botswana, where tuberculosis is common and about 90 percent of children receive BCG vaccines at birth.

Reliable evidence of past BCG vaccination was available for 96 percent of the children. All were PPD tested in the standard manner, examined for a BCG scar (indicating a significant immune response to the vaccine), and questioned about possible TB exposures and symptoms. Only 58 children (7 percent) had PPD reaction scars of 10 mm or more and 108 (14 percent) had reaction scars between 1 mm and 9 mm.

C…