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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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