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This made-up example shows the
difference between the relative and absolute risk of transmission. The
cross symbolizes the index case, filled circles infected persons, and
hollow circles non-infected persons. The two large circles indicate
increasingly less close contacts from center to periphery. In the
most inner circle three out of ten close contacts were infected, a risk of
30%. Among intermediate contacts three out of 20, a risk of
15%. Among casual contacts the denominator is not known, but
the risk is small, but nevertheless four persons were infected. Thus,
the risk is highest among those with the closest (longest)
exposure, yet the total number of people infected by the index case
outside those in close contacts may exceed the number infected
among those in close contact. This explains
why, in a tuberculin skin test survey, a large proportion among those found
infected have no recollection of ever having been exposed to a
tuberculosis patient.
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