PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of pubhealthrepLink to Publisher's site
 
Public Health Rep. 1996 Jan-Feb; 111(1): 26–33.
PMCID: PMC1381737

The need for epidemic intelligence.

Abstract

The past decade has witnessed an unprecedented upturn in tuberculosis morbidity and outbreaks of difficult- to-treat and highly lethal multidrug-resistant tuberculosis. In the early 1990s, a national consensus developed among public health officials to define more comprehensively the problem, and in January 1993, expanded tuberculosis surveillance was implemented nationwide. Carefully selected epidemiologic and case management variables were added to the Report of Verified Case of Tuberculosis form. Information is collected on the health status and treatment of patients, including human immunodeficiency virus status, drug susceptibility test results, and the initial drug regimen. Completion of therapy and use of directly observed therapy are also monitored. The new surveillance system allows a comparison of the quality of care of patients in the public and private sectors. Additional epidemiologic variables include membership in high-risk groups (the homeless, residents of correctional or long-term care facilities, migrant workers, health care workers, and correctional employees) and substance abuse (injecting drug use, non-injecting drug use, and excess alcohol use). The additional information derived from expanded tuberculosis surveillance is crucial to optimal patient management, policy development, resource allocation, as well as program planning, implementation, and evaluation at Federal, State, and local levels.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (2.9M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Images in this article

Click on the image to see a larger version.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Rieder HL, Cauthen GM, Kelly GD, Bloch AB, Snider DE., Jr Tuberculosis in the United States. JAMA. 1989 Jul 21;262(3):385–389. [PubMed]
  • Bloch AB, Rieder HL, Kelly GD, Cauthen GM, Hayden CH, Snider DE. The epidemiology of tuberculosis in the United States. Semin Respir Infect. 1989 Sep;4(3):157–170. [PubMed]
  • Barnes PF, Bloch AB, Davidson PT, Snider DE., Jr Tuberculosis in patients with human immunodeficiency virus infection. N Engl J Med. 1991 Jun 6;324(23):1644–1650. [PubMed]
  • Snider DE, Jr, Roper WL. The new tuberculosis. N Engl J Med. 1992 Mar 5;326(10):703–705. [PubMed]
  • Snider DE, Jr, Roper WL. The new tuberculosis. N Engl J Med. 1992 Mar 5;326(10):703–705. [PubMed]
  • Cantwell MF, Snider DE, Jr, Cauthen GM, Onorato IM. Epidemiology of tuberculosis in the United States, 1985 through 1992. JAMA. 1994 Aug 17;272(7):535–539. [PubMed]
  • Cantwell MF, Snider DE, Jr, Cauthen GM, Onorato IM. Epidemiology of tuberculosis in the United States, 1985 through 1992. JAMA. 1994 Aug 17;272(7):535–539. [PubMed]
  • Kent JH. The epidemiology of multidrug-resistant tuberculosis in the United States. Med Clin North Am. 1993 Nov;77(6):1391–1409. [PubMed]
  • Small PM, Schecter GF, Goodman PC, Sande MA, Chaisson RE, Hopewell PC. Treatment of tuberculosis in patients with advanced human immunodeficiency virus infection. N Engl J Med. 1991 Jan 31;324(5):289–294. [PubMed]
  • Selwyn PA, Hartel D, Lewis VA, Schoenbaum EE, Vermund SH, Klein RS, Walker AT, Friedland GH. A prospective study of the risk of tuberculosis among intravenous drug users with human immunodeficiency virus infection. N Engl J Med. 1989 Mar 2;320(9):545–550. [PubMed]
  • Rieder HL, Cauthen GM, Comstock GW, Snider DE., Jr Epidemiology of tuberculosis in the United States. Epidemiol Rev. 1989;11:79–98. [PubMed]
  • Iseman MD, Sbarbaro JA. The increasing prevalence of resistance to antituberculosis chemotherapeutic agents: implications for global tuberculosis control. Curr Clin Top Infect Dis. 1992;12:188–207. [PubMed]
  • Iseman MD. Treatment of multidrug-resistant tuberculosis. N Engl J Med. 1993 Sep 9;329(11):784–791. [PubMed]
  • Goble M, Iseman MD, Madsen LA, Waite D, Ackerson L, Horsburgh CR., Jr Treatment of 171 patients with pulmonary tuberculosis resistant to isoniazid and rifampin. N Engl J Med. 1993 Feb 25;328(8):527–532. [PubMed]
  • Mahmoudi A, Iseman MD. Pitfalls in the care of patients with tuberculosis. Common errors and their association with the acquisition of drug resistance. JAMA. 1993 Jul 7;270(1):65–68. [PubMed]
  • Iseman MD, Cohn DL, Sbarbaro JA. Directly observed treatment of tuberculosis. We can't afford not to try it. N Engl J Med. 1993 Feb 25;328(8):576–578. [PubMed]
  • Nardell EA. Beyond four drugs. Public health policy and the treatment of the individual patient with tuberculosis. Am Rev Respir Dis. 1993 Jul;148(1):2–5. [PubMed]
  • Nolan CM. Incorporation of pyrazinamide into community-wide treatment of tuberculosis. Am J Public Health. 1990 Dec;80(12):1525–1526. [PubMed]
  • Brudney K, Dobkin J. Resurgent tuberculosis in New York City. Human immunodeficiency virus, homelessness, and the decline of tuberculosis control programs. Am Rev Respir Dis. 1991 Oct;144(4):745–749. [PubMed]
  • Feingold AO. Association of tuberculosis with alcoholism. South Med J. 1976 Oct;69(10):1336–1337. [PubMed]
  • Reichman LB, Felton CP, Edsall JR. Drug dependence, a possible new risk factor for tuberculosis disease. Arch Intern Med. 1979 Mar;139(3):337–339. [PubMed]
  • Braun MM, Byers RH, Heyward WL, Ciesielski CA, Bloch AB, Berkelman RL, Snider DE. Acquired immunodeficiency syndrome and extrapulmonary tuberculosis in the United States. Arch Intern Med. 1990 Sep;150(9):1913–1916. [PubMed]
  • Friedman LN, Sullivan GM, Bevilaqua RP, Loscos R. Tuberculosis screening in alcoholics and drug addicts. Am Rev Respir Dis. 1987 Nov;136(5):1188–1192. [PubMed]
  • Alvarez S, Shell C, Berk SL. Pulmonary tuberculosis in elderly men. Am J Med. 1987 Mar 23;82(3 Spec No):602–606. [PubMed]
  • Barnes PF, Leedom JM, Chan LS, Wong SF, Shah J, Vachon LA, Overturf GD, Modlin RL. Predictors of short-term prognosis in patients with pulmonary tuberculosis. J Infect Dis. 1988 Aug;158(2):366–371. [PubMed]
  • Weis SE, Slocum PC, Blais FX, King B, Nunn M, Matney GB, Gomez E, Foresman BH. The effect of directly observed therapy on the rates of drug resistance and relapse in tuberculosis. N Engl J Med. 1994 Apr 28;330(17):1179–1184. [PubMed]
  • Frieden TR, Fujiwara PI, Washko RM, Hamburg MA. Tuberculosis in New York City--turning the tide. N Engl J Med. 1995 Jul 27;333(4):229–233. [PubMed]
  • Bayer R, Wilkinson D. Directly observed therapy for tuberculosis: history of an idea. Lancet. 1995 Jun 17;345(8964):1545–1548. [PubMed]
  • Gostin LO. Controlling the resurgent tuberculosis epidemic. A 50-state survey of TB statutes and proposals for reform. JAMA. 1993 Jan 13;269(2):255–261. [PubMed]
  • Bayer R, Dubler NN, Landesman S. The dual epidemics of tuberculosis and AIDS: ethical and policy issues in screening and treatment. Am J Public Health. 1993 May;83(5):649–654. [PubMed]
  • Thacker SB, Berkelman RL. Public health surveillance in the United States. Epidemiol Rev. 1988;10:164–190. [PubMed]
  • FOLDI M, KOVACH AG, SOLTI F, REV J, REFI Z, HERMANN R, KOLTEY E. Uber Crataeguswirkungen auf die Nierenfunktion beim Menschen. Dtsch Med J. 1959 Apr 1;10(6):164–166. [PubMed]

Articles from Public Health Reports are provided here courtesy of Association of Schools of Public Health