The purpose of the skin sensitivity test was to determine whether you had enough antibodies against TB in your bloodstream to produce an adverse reaction to the BCG vaccination. When Dr Heaf first introduced his test in 1951, he listed five grades, negative and positive grades 1 to 4, depending upon the severity of the reaction. Because this classification lead to very large numbers of unnecessary further investigations, these were fairly quickly redefined as grades 0 to 4, with grades 0 and 1 both being classed as negative. That didn't mean that people who showed a grade 1 reaction did not have latent TB, but that their body was not reacting severely enough to cause problems if they were given the vaccination.
Specifically, antibiotic resistant TB strains are *the* serious problem as with the many antibiotic strains of other species of bacteria which have also evolved resistance over the hundreds of thousands of generations that have passed since the late 1940s when antibiotics became more readily available to "Medical Science" as the 'magic bullet' cure all solution to the problem of dealing with bacterial infections.
Darwin would have been well impressed at the great lengths "Medical Science" has gone to in proving the immutable truth of his theory over and over during the past 70 years or so that this 'Great Experiment' has been running.
There was an NHS in 1955. In any case TB treatment has been free for at least 100 years, probably much longer.
A person with infectious TB would be seriously ill, and would be unlikely to recover without treatment.
A young person with TB today would be treated as an out-patient. I doubt if drug treatment would last for more than a month. The patient would obviously be followed for longer than that. But for most patients the illness would be about as serious as a bad case of flu.
I don't think any of the drugs currently used has unpleasant side effects in the vast majority of patients.
I don't think that is true. The principal purpose of the Mantoux test was to determine if you were immune to TB (in which case you had a positive reaction, shown by a small bump in the skin).
I don't know who Dr Heaf is, but the Mantoux test is over 100 years old.
Your use of the term "latent TB" here is seriously misleading. You might as well say that someone who has been vaccinated against polio has "latent polio". The Mantoux test simply determines if a person has antibodies against TB.
The question of whether the skin sensitivity test was necessary before BCG vaccination has been covered in many papers, from the 1960s onwards. Despite the fact that dropping it and just mass vaccinating school children would have saved the Department of Health a lot of money, the conclusion was always reached that the skin sensitivity test was essential. The potential consequences of vaccinating somebody who would react strongly were simply too serious to do otherwise. I've seen pictures where almost the entire upper arm had atrophied as a result of vaccination without a prior skin test.
A positive result shows exposure to the disease and, far from demonstrating immunity, it indicates a need for further clinical tests, to determine the extent of the exposure and whether or not the disease is currently active.
The Heaf test was the standard skin sensitivity test in the UK from 1951 until mass testing was ended in 2005. It was also used in parts of Ireland, South Africa and Australia. It comprised firing a pattern of six needles into the inner skin of the forearm, through a prepared protein derivative of TB and looking at what reaction, if any, there was, after 3-10 days.
It has a number of advantages over the Mantoux test, notably speed of testing and a lower drop out rate. Using the Heaf test around 300 pupils could be tested in a single school session, as compared to 100 using the Mantoux test. The Heaf test also only required two clinical visits, as compared to three for the Mantoux test and it was estimated that, in a mass testing environment, each visit resulted in a non-attendance by about 10% of patients.
Except that I didn't suggest that somebody who had been vaccinated had latent TB.
The point I was making was that, although a Grade 1 Heaf test result was considered to be negative for the purposes administering a BCG vaccination, only a Grade 0 negative result actually showed a complete lack of exposure to the disease. Hence, a negative Heaf test result did not necessarily rule out the presence of latent TB.
Harry would almost certainly have had the Heaf test.
The standard treatment for pulmonary TB is isoniazid and rifampicin administered every day for six months, with pyrazinamide and ethambutol also adminstered every day for the first two months. For extrapulmonary TB, the course might be as long as 12 months.
Liver and eye damage are both possible side effects.
You and me both! I had the test around 1962/3, still at primary school, and can still remember the queue, with horror stories circulating of six huge needles etc. The actuality was nothing like as bad as the scary stories.
Indeed. I was not fond of needles then, and nothing much has changed. Funnily enough, I had a blood test last week, by the practice nurse. No, it did not really hurt, but I didn't enjoy it. She bruised my arm, though. That was Thursday, and inside elbow is still bruised.
A TB nurse told me that one of the things she liked about the disposable Heaf test gun I designed in the 1980s was that the needles were completely hidden from the patient. It made giving the test to nervous patients much easier.
My surgery has a dedicated phlebotomist for taking blood samples. She is much better at it than any of the practice nurses.
A practice I used to use had that, and it took place in the building's basement. My cardiologist, who was Rumanian by birth, used to say he was sending me to the 'vampires in the basement' to get my blood drawn.
Me too, but luckily I wasn't the worst the Capatin of the school football team passed out when he saw the 'device' which looked like a gattling gun with needles.
Just to include a little DIY related triva: The original Heaf test gun used a Moore and Wright automatic centre punch body, fitted with a different nose piece that held the needles.
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