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