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Kristian Andvord’s break-through observation. Andvord K F. Norsk Magasin for Lægevidenskapen 1930;91:642-60. The “Koch Phenomenon”. A primary infection leads to a delayed response and has often a mild and self-limited course

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Kristian Andvord’s break-through observation

Andvord K F. Norsk Magasin for Lægevidenskapen 1930;91:642-60


The “Koch Phenomenon”

A primary infection leads to a delayed response and has often a mild and

self-limited course

A reinfection results commonly in a rapid response with tissue necrosis

Drawings: Koch R. Mittheilungen aus dem Kaiserlichen Gesundheitsamte 1884;2:1-88.

Phenomenon: Koch R. Dtsch Med Wochenschr 1891;17:101-2.


Andvord

Canetti

Re-infection

Morbidity / mortality

Remaining live bacilli

Birth cohort

Primary

infection

Cross-sectional

A

B

Age

Time / age

Koch

BMRC BCG Trial

Progressive

Re-infection

Abortive

Tissue destruction

BCG protection

Primary

infection

C

D

Time

Time


Effect of Environmental Mycobacteria:

Blocking and Masking Hypothesis

Andersen P, et al. Nature Rev 2005;3:656-62


…and another research question:

If an individual is not protected by BCG, is

tuberculosis more severe in this individual?


Operating Characteristics of IGRAs

Pai M, et al. Expert Rev Mal Diagn 2006;6:413-22



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