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A Prescription for Change

Eran Bellin, MD

JAMA. 1994;271(9):708-709.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

The dramatic increase in tuberculosis (TB) incidence¹ is testimony to the failure of the United States to coordinate its medical care provision, disease surveillance, and societal will to consistently provide TB therapy and monitor TB control.² In this issue of THE JOURNAL, Bloch and colleagues³ demonstrate a remarkable shift in the epidemiology of TB in the United States.

In the 1970s, US health officials believed that indigenous TB was coming under control, its ultimate elimination possible with only an occasional case reactivating in the elderly. Transient increases in TB incidence were attributed to immigrants, such as the Indochinese refugees in the mid 1970s⁴ and Philippine national World War II veterans in Hawaii in the 1990s.⁵ These foreign cases brought with them the peril of drug resistance as a result of the indiscriminate and inconsistent use of TB medications in the immigrants' countries of origin. Bloch . . . [Full Text PDF of this Article]

Author Affiliations
From the Infectious Disease Service, Montefiore—Rikers Island Health Service, East Elmhurst, NY, and Department of Epidemiology and Social Medicine, Albert Einstein College of Medicine, Bronx, NY.

Footnotes
Reprint requests to Infectious Disease Service, Montefiore—Rikers Island Health Service, 15-15 Hazen St, East Elmhurst, NY 11370 (Dr Bellin).

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