TUBERCULOSIS AT THE END OF THE 20TH-CENTURY

Tuberculosis has once again emerged as a significant public health pro blem in Western countries. Much of the rise has been fueled by the gro wing numbers of persons infected with HIV. Co-infection with Mycobacte rium tuberculosis and HIV has been shown to result in high rates of ac tive tuberculosis, and possibly in acceleration of progression to AIDS . Primary tuberculosis occurs at high rates among dually infected pers ons, further emphasizing the need for effective isolation of infectiou s cases. Recent preliminary studies have demonstrated that the surviva l of persons with multidrug-resistant tuberculosis can be six months a nd longer, far in excess of the 4 to 12 weeks reported previously. At least seven health care workers have died of occupationally-acquired m ultidrug-resistant tuberculosis, making control of the spread of tuber culosis in health care settings an urgent public health priority.