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Tuberculosis in the Healthcare Setting in the 1990s: From Bird Island to the Bronx

Published online by Cambridge University Press:  21 June 2016

Susan E. Beekman*
Affiliation:
Hospital Epidemiology Service, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland
Michael T. Osterholm
Affiliation:
Acute Disease Epidemiology Section, Minnesota Department of Health, Minneapolis, Minnesota
David K. Henderson
Affiliation:
Hospital Epidemiology Service, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland Office of the Director, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland
*
Building 10, Room 4A-21, National Institutes of Health, 9000 Rockvitte Pike, Bethesda, MD 20892

Extract

Our nation's attention has recently been focused on the resurgence of tuberculosis as a significant public health problem. The human immunodeficiency virus (HIV) epidemic has played a seminal role in this development. In addition, the concurrent increase in poverty and homelessness, particularly in our inner cities, and the changes in patterns of immigration into the United States have also played a contributing role. Finally, the deterioration of our public health infrastructure, together with decreasing access to medical care, served as the perfect breeding environment for Mycobacterium tuberculosis infection to gain new and dangerous ground. The abrupt change in 1985 in the persistently downward trend in the incidence of tuberculosis cases in the U.S. signaled the first “shot across the bow” in what is now a full-scale war against this old enemy. In the 1990s, tuberculosis has now resumed its historical position of importance and danger in our inner cities. Tuberculosis control strategies -- once thought to be destined solely for the history books -- have regained public health and institutional attention, especially in settings serving inner-city, impoverished, or immunosuppressed populations.

Type
Aids
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1993

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References

1. Fischi, MA, Uttamchandani, RB, Daikos, GL, et al. An outbreak of tuberculosis caused by multiple-drug-resistant tubercle bacilli among patients with HIV infection, Ann Intern Med. 1992;117:177183.Google Scholar
2. Fischl, MA, Daikos, GL, Uttamchandani, RB, et al. Clinical presentation and outcome of patients with HIV infection and tuberculosis caused by multiple-drug-resistant bacilli. Ann Intern Med. 1992;117:184190.Google Scholar
3. Pearson, ML, Jereb, JA, Frieden, TR, et al. Nosocomial transmission of multidrug-resistant Mycobacterium tuberculosis; a risk to patients and healthcare workers. Ann Intern Med. 1992:117:191196.Google Scholar
4. Beck-Sague, C, Dooley, SW, Hutton, MD, et al. Hospital outbreak of multidrug-resistant Mycobacterium tuberculosis infections: factors in transmission to staff and HIV-infected oatients. JAMA. 1992;268:12801286.Google Scholar
5. Frieden, TR, Sterling, T, Pablos-Mendez, A, Kilbum, JO, Cauthen, GM, Dooley, SW. The emergence of drug-resistant tuberculosis in New York City. N Engl J Med. 1993; 28:521526.Google Scholar
6. Goble, M, Iseman, MD, Madsen, LA, Waite, D, Ackerson, L, Horsburgh, CR. Treatment of 171 patients with pulmonary tuberculosis resistant to isoniazid and rifampin. N Engl J Med. 1993;328:527532.Google Scholar
7. Iseman, MD, Cohn, DL, Sbarbaro, JA. Directly observed treatment of tuberculosis: we can't afford not to try it. N Engl J Med. 1993;328:576578.Google Scholar
8. Di Perri, G, Cadeo, G, Castelli, F, et al. Transmission of HIV-associated tuberculosis to healthcare workers. Infect Control Hosp Epidemiol. 1993;14:6772.Google Scholar
9. Centers for Disease Control. Update: tuberculosis elimination—United States. MMWR 1990;39:153156.Google Scholar
10. Centers for Disease Control. Guidelines for preventing the transmission of tuberculosis in healthcare settings, with special focus on HIV-related issues. MMWR. 1990;39:129.Google Scholar
11. Department of Labor/Occupational Safety and Health Administration. Joint advisory notice. Federal Register. 1991;56:6400464182.Google Scholar
12. Centers for Disease Control. Recommendations for preventing transmission of human immunodeficiency virus and hepatitis B virus to patients during exposure-prone invasive procedures. MMWR. 1991;40:19.Google Scholar
13. Osterholm, MT, Garayalde, SM. Clinical viral hepatitis B among Minnesota hospital personnel. JAMA 1985;254:32073212.Google Scholar