Tuberculosis Study Puts Focus on Foreigners

AP 13dec00

CHICAGO -- Immigrants account for more than 40 percent of all tuberculosis cases in the United States, suggesting that government efforts to eliminate TB should focus on foreigners, researchers reported.

The nation's overall tuberculosis rate has dropped to an all-time low -- 17,531 active cases last year.

Active cases among immigrants climbed 2.6 percent from 7,402 in 1993 to 7,591 in 1998, researchers from the Centers for Disease Control and Prevention reported in Wednesday's Journal of the American Medical Association.

During that time, the proportion of U.S. cases involving immigrants increased from about 30 percent to 41.6 percent. At that pace, it will exceed 50 percent by 2002, the researchers said.

Most cases were in people from Mexico, the Philippines, Vietnam, China, India, Haiti and South Korea -- countries where TB is prevalent.

The findings suggest that some cases may have been contracted abroad but stayed dormant until after the immigrants moved to the United States.

Under current U.S. policy, prospective immigrants must get chest X-rays to detect active infections, but not TB skin tests, which can detect latent infections.

Crowded living conditions in some immigrant communities and poor access to health care also may contribute to the infection's spread.

The World Health Organization estimates that 2 billion people -- one-third of the world's population -- are infected, but many have dormant infections, which are not contagious and usually do not develop into active disease. Antibiotics can control tuberculosis.

Control efforts should include screening for dormant infections, including TB skin tests, said co-author Dr. Marisa Moore.