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In children, as in adults, tuberculosis is much commoner among minority population groups, in Louisiana particularly among blacks. Since 1986 tuberculosis in some states has increased notably; in Louisiana the increase is only now, in 1992, becoming apparent. Eighteen new cases in children under 20 were reported in 1991. Diagnosis in children still depends largely on history of contact and on the Mantoux tuberculin test. Treatment has changed markedly to a more intensive 6 month course including three or four drugs. Preventive treatment of tuberculin positive children is particularly emphasized because it will play an important role in achieving the stated public health goal of elimination of tuberculosis by the year 2010. With the increasing number of children exposed to tuberculosis, the increasing number of HIV-positive children at risk, and the rising number of multiresistant tubercle bacilli, vaccination with BCG must be considered.

The prevalence and titers of antibodies to capsid antigens of Epstein-Barr virus ad to the diffuse and restricted components of the Epstein-Barr virus-induced early antigen complex were determined in 109 families of a semirural community in Louisiana. Titers of antibody to the capsid antigens larger than or equal to 10 were found in 84 percent of children aged two to five years, and the prevalence increased with age to nearly 100 percent. There was a positive but variable correlation of the prevalence of anti-capsid antigen reactivity with low socioeconomic status and crowding. An overrepresentation of high titers of antibody to capsid antigens was present in individuals with a past history of pneumonia and urinary tract infections. The geometric mean titers of antibody to capsid antigens were highest in early childhood, lowest in adolescence and young adulthood, and high in the elderly. Females in all age groups and tonsillectomized children showed a higher geometric mean titer than their male and nontonsillectomized counterparts, respectively. Antibodies to the early antigen complex were found rarely (8.2 percent) and only in sera with relatively high titers of antibody to capsid antigens.

Fifty-nine cases of tuberculous meningitis in children seen at the Charity Hospital at New Orleans since the addition of isoniazid to the therapy in 1952 are reviewed. Fourteen of the children died during hopsitalization. At discharge 21 children had complete or nearly complete clinical recovery. Follow-up of 21 available long-term survivors revealed a significant number with neurologic and social disabilities. The endemicity of tuberculous infections in the households of the children and factors responsible for transmission of tubercle bacilli from an adult source are reported. The importance of chemoprophylaxis and public health measures in eliminating this disease are stressed.