Tuberculosis Health Article

Prophylactic use of isoniazid

INH can be given for the prevention as well as the treatment of TB. INH is effective when given daily over a period of 6 to 12 months to people in high-risk categories. INH appears to be most beneficial to persons under the age of 25. Because INH carries the risk of side-effects (liver inflammation, nerve damage, changes in mood and behavior), it is important to give it only to persons at special risk.

High-risk groups for whom isoniazid prevention may be justified include:

• close contacts of TB patients, including health care workers
• newly infected patients whose skin test has turned positive in the past two years
• anyone who is HIV-positive with a positive PPD skin test; isoniazid may be given even if the PPD results are negative if there is a risk of exposure to active tuberculosis
• intravenous drug users, even if they are negative for HIV
• persons with positive PPD results and evidence of old disease on the chest x-ray who have never been treated for TB
• patients who have an illness or are taking a drug that can suppress the immune system
• persons with positive PPD results who have had intestinal surgery; have diabetes or chronic kidney failure; have any type of cancer; or are more than 10% below their ideal body weight
• people from countries with high rates of TB who have positive PPD results
• people from low-income groups with positive skin test results
• persons with a positive PPD reaction who belong to high-risk ethnic groups (African Americans, Hispanics, Native Americans, Asians, and Pacific Islanders)

BOOKS

Merck Manual of Medical Information: Home Edition. Ed. Robert Berkow, et al. Whitehouse Station, NJ: Merck Research Laboratories, 1997.

Smolley, Lawrence A., and Debra F. Bryse. Breathe Right Now: A Comprehensive Guide to Understanding and Treating the Most Common Breathing Disorders. New York, NY: W. W. Norton & Co., 1998.

ORGANIZATIONS

American Lung Association. 1740 Broadway, New York, NY 10019. (800) 586-4872. <http://www.lungusa.org>.

OTHER

New York State Department of Health. "Communicable Disease Fact Sheet."

"Pulmonary Medicine." Healthweb Page. 12 Jan. 1998 <http://healthweb.org/browse.cfm?subjectid=81>.

David A. Cramer, MD

FLORENCE B. SEIBERT (1897–1991)

Florence Barbara Seibert was born on October 6, 1897, in Easton, Pennsylvania, the second of three children. She was the daughter of George Peter Seibert, a rug manufacturer and merchant, and Barbara (Memmert) Seibert. At the age of three she contracted polio. Despite her resultant handicaps, she completed high school, with the help of her highly supportive parents, and entered Goucher College in Baltimore, where she studied chemistry and zoology. She graduated in 1918, then worked under the direction of one of her chemistry teachers, Jessie E. Minor, at the Chemistry Laboratory of the Hammersley Paper Mill in Garfield, New Jersey. She and her professor, having responded to the call for women to fill positions vacated by men fighting in World War I, coauthored scientific papers on the chemistry of cellulose and wood pulps.

A biochemist who received her Ph.D. from Yale University in 1923, Florence B. Seibert is best known for her research in the biochemistry of tuberculosis. She developed the protein substance used for the tuberculosis skin test. The substance was adopted as the standard in 1941 by the United States and a year later by the World Health Organization. In addition, in the early 1920s, Seibert discovered that the sudden fevers that sometimes occurred during intravenous injections were caused by bacteria in the distilled water that was used to make the protein solutions. She invented a distillation apparatus that prevented contamination. This research had great practical significance later when intravenous blood transfusions became widely used in surgery. Seibert authored or coauthored more than a hundred scientific papers. Her later research involved the study of bacteria associated with certain cancers. Her many honors include five honorary degrees, induction into the National Women's Hall of Fame in Seneca Falls, New York (1990), the Garvan Gold Medal of the American Chemical Society (1942), and the John Elliot Memorial Award of the American Association of Blood Banks (1962).