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作者提到,在2000年美国要把结核病减少到一个偶发的水平,主要通过以下两方面的工作:(1)保证患者不中断化疗;(2)对已感者进行化疗预防,这里未提及卡介苗的问题。认为美国及大部分发达国家,卡介苗接种仅起有限作用,其理由是:大规模接种不易推行;因接种引起的少数患病确实存在;各种菌株获得保护力差异很大;更重要的是现在流行病学情况(大多数病例出现于已受感染者,即阳性反应者,接种对他们既不适合也无利),这些因素使卡介苗接种在国家防治规划中成为无效和浪费。 1950～1960年,美国公共卫生组织(USPHS)
The author mentions that in the United States in 2000, tuberculosis should be reduced to an incidental level mainly through the following two tasks: (1) to ensure that patients will not be interrupted with chemotherapy; and (2) to have chemoprevention of those who have been infected, not mentioned here BCG problem. In the United States and in most of the developed countries, BCG vaccination is considered to have only a limited role because of the following: large-scale vaccination is not easy to carry out; the few diseases caused by vaccination do exist; and the protective effect of various strains varies greatly; more importantly, Epidemiological conditions, most of which occur in persons who are already infected (ie, positive ones, neither of whom are suitable nor unfit to vaccinate), have rendered BCG vaccination ineffective and wasteful in national programs of control. From 1950 to 1960, the U.S. Public Health Organization (USPHS)