Why were tuberculosis sufferers sent to sanatoriums?

[Janet in Yorkshire]

A lot of people got TB from drinking milk from infected cows - TT testing of cows was only introduced around 1950. Poor diets, often low in proteins, lowered immunity to the disease.
Sadly the risk of TB infection is again increasing in today's cosmopolitan world; one possible source of infection is re-cycled air in aircraft, especially on long-haul flights, according to the consultant who treated me for TB bugs in my system. The TB bugs have mutated over the years and it is becoming increasingly difficult to develop new strains of medication to keep pace. I didn't have full-blown TB, just indications of a dormant potential to develop it in later life. Treatment was a 3 month course of very strong antibiotics, with a dire warning that I must see my consultant immediately if I missed even one dose, as this could negate the whole treatment and it would mean starting all over again with a different medication, which may not work.
The cause of my infection was thought to have been "foreign" travel - being coughed on by an infected person, or imbibing infected milk (the irony of that is that I've never liked milk and drink black tea.)

Jay

[Sue1]

Had you had a BCG as a child?

[Janet in Yorkshire]

Yes I'd had the skin test when a child, which showed I had a natural immunity and didn't need the jab.
How I discovered the problem was that a worker in another part of the building was diagnosed with TB and we all had to be tested. As a result of the skin test, several of us (all over 40) had reactions and were sent for chest x-rays and to see a consultant, although none of us actually worked in the same department as the original case.
After a consultation, myself and another colleague were put on a three months course of medication "as a precaution." The nearest and dearest of neither of us were thought to be in need of screening.
The TB sufferer was thought to have contracted the disease whilst on holiday abroad, which was also suggested to me. She had had a terrible cough for several weeks; ironically, she was very "anti-smoking" and had never ceased to admonish me and other colleagues whenever she saw us smoking, and when she started coughing, we had teased her that she must secretly be a 40 a day closet smoker! She was put on a course of very strong medications and was off work for 6 months until she was pronounced "clear."

Jay

[Sue1]

I can remember at about the age of 13 we all had Mantoux tests at school - the vast majority of the class, including myself, were positive and were taken off to Kingston Hospital for chest x-rays. I have never had a BCG as it was considered unnecessary as, like you, I had natural immunity.
I think in recent times very few children have positive Mantoux tests - the majority who do are from Eastern Europe, the Indian subcontinent and Republic of Ireland nowadays.
In those who have a "natural immunity" it is not as clear cut as that I understand - that initial infection that gives "immunity" (called a Gohn focus i.e. a "patch on the lung") can be reactivated in some cases.
Patient's with "active" TB used to be given triple therapy, mainly Paramino salicylic acid, Izoniazid and one other which I can't remember the name of. I dare say that no longer works - not sure what is used these days.

[Olde Crone Holden]

In the 70s I worked with a 50 year old woman who had had TB 20 years before and was sent to a sanatorium. She did not see her little girl for almost three years and said that they had had a very difficult relationship since.

Antibiotics did not work in her case (or not immediately) and she had fresh air therapy - they all slept outside in iron beds with a sort of tarpaulin cover over to keep off the damp. She said she found it very difficult to sleep indoors when she finally got home.

OC

[Sue1]

I think in some cases, when those with "active" Tb lived at home (and couldn't actually live in close contact with the family) a "hut" would be erected in the garden and they slept there (my mother had a cousin who had to live in that way - he didn't survive). Cutlery and crockery had to be put in boiling water. Those who are not coughing up sputum with the tubercle bacilli in it, do not apparently need to be segregated; those with the bacilli present do need to be isolated.
With children it is very difficult to get a specimen of sputum (used to be done by taking a laryngeal swab from adults if they couldn't "cough up") and the only way to get a specimen from a child was by inserting a gastric tube and taking a specimen from their gastric contents - children cough and swallow. It used to be heartrending to hear a child crying and promising "to be good" if the tube was not inserted. I sincerely hope things have changed.