Medicine: The Case Against T. B.

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Tuberculosis, the White Plague, has not been cleaned up anywhere in the world, nor is it "under control." In the U.S. an estimated 500,000 people still have the disease, and about 50,000 die from it every year.

People had better face these gloomy facts, says Dr. Edward J. O'Brien, 62, president of the Michigan State Tuberculosis Sanatorium Commission. This week in Denver, addressing the annual meeting of the American Association for Thoracic Surgery, of which he is also president, Dr. O'Brien told his colleagues that he was pretty well fed up with the lackadaisical attitude of the U.S. toward T.B. vaccination.

Recently back from a world tour (at his own expense), during which he saw that tuberculosis is still riding high and fast in almost every country, Dr. O'Brien is convinced that the only hope of wiping out the disease lies in mass vaccination with the vaccine called BCG (for bacillus of Calmette and Guérin, the French scientists who developed it from 1908 to 1924). But health officials in the U.S., O'Brien charges, have neglected using BCG "through ignorance of its efficiency and misunderstandings* regarding its harmlessness."

BCG is of no help to people who already have tuberculosis. But many bacteriologists and doctors believe that if every infant in the world were to be vaccinated with BCG, the disease would be wiped out completely within a few generations.

Said Dr. O'Brien: "Let us have the honesty to accept the futility of our present methods alone, and the courage to embark immediately on a program of extensive BCG vaccinations, without which tuberculosis will present the same problems a thousand years from now as it does today. Unless we use vaccination as in smallpox and diphtheria, there is, in my opinion, no hope . . ."

One of the major jobs done thus far by BCG has been in occupied Japan, where some 31 million BCG vaccinations have been given since V-J day. In the vaccinated group, mortality has been cut by 88%. Three laboratories in the U.S. manufacture BCG, but so far the U.S. Public Health Service has not licensed them to distribute the culture for mass vaccinations. Dr. William G. Workman, chief of biologics control of the P.H.S., said in Washington last week that he did not know exactly when P.H.S. approval would be given.