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Current Trends Tuberculosis Provisional Data -- United States, 1986

In 1986, a provisional total of 22,575 tuberculosis cases was reported to CDC. This was an increase of 374 cases (1.7%) over the 1985 final total of 22,201 cases (Figure 4). In 1986, the provisional incidence rate was 9.4/100,000 population, a 1.1% increase from the 1985 final rate of 9.3/100,000. Reported by: Div of Tuberculosis Control, Center for Prevention Svcs, CDC.

Editorial Note

Editorial Note: For the period 1982-1984, the incidence of tuberculosis declined an average of 1,706 cases (6.7%) a year. In 1985, this steadily downward trend halted when there was a decline of 54 cases (0.2%). The increase in cases in 1986 marks the first substantial rise in indigenous tuberculosis morbidity in the United States since 1953, when national reporting of tuberculosis was fully implemented.

While the reasons for this increase are not fully known, available evidence suggests that persons infected with both the human immunodeficiency virus (HIV) and the tubercle bacillus account for part of the change in morbidity (1-6). Matching of AIDS and tuberculosis registries in 24 states and four localities indicates that 645 (4.2%) of 15,181 patients with AIDS have also had tuberculosis. In addition, an increase in tuberculosis among minorities (4), the homeless, and persons born in foreign countries may be contributing to the overall increase in morbidity.

The impact of AIDS and HIV infection on tuberculosis morbidity in the United States would be better understood if all health departments would match AIDS and tuberculosis registries. Health departments should routinely offer HIV testing and counseling to patients with tuberculosis, and the confidentiality of results should be assured. Individuals with both HIV and tuberculous infection should be managed according to recently published guidelines (7).

References

  1. CDC. Tuberculosis and acquired immunodeficiency syndrome--Florida. MMWR 1986;35:587-90.

  2. Stoneburner RL, Kristal A. Increasing tuberculosis incidence and its relationship to acquired immunodeficiency syndrome in New York City. Presented at the International Conference on the Acquired Immunodeficiency Syndrome (AIDS), Atlanta, Georgia, April 1985.

  3. CDC. Tuberculosis--United States, 1985--and the possible impact of human T-lymphotropic virus type III/lymphadenopathy-associated virus infection. MMWR 1986;35:74-6.

  4. CDC. Tuberculosis--United States, 1985. MMWR 1986;35:699-703.

  5. Chaisson RE, Theuer CP, Schecter GF, Rutherford GW, Echenberg DF, Hopewell PC. Clinical aspects of tuberculosis in AIDS patients: a population based study. Presented at the Second International Conference on the Acquired Immunodeficiency Syndrome (AIDS), Paris, France, June 1986.

  6. Sunderam G, McDonald RJ, Maniatis T, Oleske J, Kapila R, Reichman LB. Tuberculosis as a manifestation of the acquired immunodeficiency syndrome (AIDS). JAMA 1986;256:362-6.

  7. CDC. Diagnosis and management of mycobacterial infection and disease in persons with human T-lymphotropic virus type III/lymphadenopathy-associated virus infection. MMWR 1986;35:448-52.



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