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Discusses the structure and functions of the National Task Force on Fetal Alcohol Syndrome and Fetal Alcohol Effect in the U.S. Disorders related to prenatal alcohol exposure; Information on fetal alcohol syndrome; Percentage of women who drink alcohol during pregnancy; Recommendations of the Task Force.

Discusses some of the ethical issues raised by the prospect of conducting tuberculosis vaccine trials in human research subjects. Appropriateness of conducting trials in developing countries; Use of a BCG-vaccinated population as the control group; Provision of tuberculin skin-test screening and preventive therapy to study participants.

Abstract: Health department officials in all 50 states and 14 major cities responded to a survey questionnaire designed to obtain information about current tuberculosis screening practices. Persons being screened fell into the groups designated as high risk by the American Thoracic Society (ATS) and the Centers for Disease Control (CDC) The methods used for screening were generally those advocated by ATS CDC and the Food and Drug Administration (FDA), although chest radiographs continue to be overused, Screening in about one-half of the groups is mandated by law or regulation. There appears to be some confusion about the circumstances in which "two-step" tuberculin testing should be used. Data on the productivity and costs of screening activities were very limited. We encourage those responsible for tuberculosis screening programs to evaluate them, discontinue those which are unproductive, and intensify those which are productive. [ABSTRACT FROM AUTHOR]

Describes the problems created for public health by the definitions of research in the Code of Federal Regulations for the Protection of Human Research Subjects. Approach to determine when public health activities are or are not research; Conclusion.

Abstract: Following a retrospective review of tuberculosis cases reported from Ottawa County, Oklahoma, from 1969 through 1973, a selective tuberculosis screening project was implemented. Screening of a "target group" of the population, 519 former miners, is greater than or equal to 50 years of age, resulted in the discovery of abnormal chest X-rays in 182; (103 with silicosis, 36 with silicotuberculosis, 12 with inactive tuberculosis, and 31 with other abnormalities). Eighty-five of these persons had positive tuberculin skin tests. Preventive therapy was recommended for 50, and 36 completed the prescribed course of treatment. Eight new bacteriologically confirmed cases of tuberculosis were found and treated. A large number of persons (1,904) residing in the same area who were not part of the target group were also screened for tuberculosis. This group contained a large number of positive tuberculin reactors but very few were candidates for isoniazid preventive therapy. Thirteen persons in this group had abnormal chest X-rays consistent with inactive tuberculosis but 12 had been identified and given preventive therapy before the project began. These data suggest that selective approaches to screening for tuberculosis in a community which are based on an in-depth retrospective review of the tuberculosis case register can be highly successful. (Am. J. Public Health 69:340-347, 1979.) [ABSTRACT FROM AUTHOR]

Discusses the trend of the tuberculosis (TB) disease in the U.S. Observation of the continuous drop of TB from 1953 until 1984; Rise of TB cases due to influx of Asian refugees and indigenous cases; Availability of morbidity data from the Centers for Disease Control; Trends of tuberculosis risk among whites and non-whites from 1953 to 1987; Implications for control efforts.

Although the number of tuberculosis cases reported annually in the United States has decreased markedly during the past three and a half decades, the decrease among whites has been considerably greater than among nonwhites. As a result of this widening gap, nearly two-thirds of the cases reported in 1987 occurred in minority populations and, for the first time in history, the number of cases among blacks exceeded the number of cases among non-Hispanic whites. From 1985 to 1987, tuberculosis among blacks increased 6.3 percent and among Hispanics, by 12.7 percent, but it decreased 4.8 percent among non-Hispanic whites. Much of the increase appears attributable to tuberculosis occurring among persons infected with the human immunodeficiency virus (HIV). Although there are many obstacles to the elimination of the disease in minority populations, numerous strategies have been developed and are being implemented to address this situation. [ABSTRACT FROM AUTHOR]

On request of local health officials, the authors investigated isoniazid (INH) hepatitis morbidity and mortality among patients attending an Hispanic prenatal clinic. Among 3,681 women treated with INH during and after pregnancy to prevent tuberculosis (TB), 5 developed INH hepatitis, and 2 of the S women died. Comparison with previously collected Public Health Service data concerning 3,948 nonpregnant women, using the Cox proportional hazards model, revealed a 2.5-fold increased risk of INH hepatitis in the prenatal clinic group. The mortality rate was four times higher in the prenatal clinic group. However, statistical power was low because of the small number of cases, and neither of these findings was statistically significant (P > 0.05). In the absence of controlled studies, the issue of INH safety during the perinatal period remains unresolved. Nevertheless, current American Thoracic Society-Centers for Disease Control recommendations regarding TB screening, implementation of INH chemoprophylaxis programs, and adequate monitoring of individuals on INH should be adhered to. The results of this investigation raise concern that deviations from existing policy may contribute to unnecessary morbidity and mortality. [ABSTRACT FROM AUTHOR]

Talks about the mission and goals of the Centers for Disease Control and Prevention (CDC). Epidemiologic and laboratory studies of malaria, typhus and plague; Strong emphasis on establishing partnerships with other organizations; Special role of behavioral and social sciences in public health.

Examines the prevalence of multidrug-resistant tuberculosis in the U.S. Background on trends in the incidence of tuberculosis in the country; Discussion on outbreaks of multidrug-resistant tuberculosis in hospitals and correctional facilities; Factors that contribute to outbreaks of multidrug-resistant tuberculosis in health care facilities and other institutions.

Presents insights on the developments with the Communicable Disease Center (CDC), established by the U.S. Public Health Service, and its services to provide public health solutions regarding infectious diseases. Changes in the name of the center; Achievements made by the staff, medical professionals and volunteers of CDC; Contributions of CDC to international health; Adoption of advanced technology.

This article reports that the tuberculosis was the leading cause of death in the U.S. At that time, consumption was incurable and dreaded as much as AIDS is today. Its victims were ostracized and sent into internal exile in sanatoria with a 50-50 chance of dying. The advent of effective anti-tuberculosis chemotherapy has changed all that and has revolutionized the approach to treatment and control of this disease. Tuberculosis is now curable and preventable. Its treatment has entered the mainstream of modern medicine, and patients can be managed successfully in an ambulatory setting. Nevertheless, tuberculosis is still a formidable adversary in our society, causing substantial morbidity and mortality. In 1984, there were 22,255 reported cases and, in 1983, the most recent year for which mortality statistics are available, there were 1,779 recorded deaths. Particularly disturbing is the continued occurrence of tuberculosis in children. In 1984, there were 1,236 reported cases among children under age 15 years, including 759 cases among children under age five. The occurrence of tuberculosis in children has double significance. First is the personal health impact to children who are afflicted by this potentially preventable disease.

Abstract: In 1974 and 1975, a selective tuberculosis screening program was conducted in a small mining community in Ottawa County, Oklahoma. Former miners, 50 years of age and over, who had abnormal chest radiographs consistent with silicosis or inactive tuberculosis and positive tuberculin skin tests, were offered isoniazid preventive therapy. Since the project ended, morbidity from silicotuberculosis has declined but silicotuberculosis has continued to occur. In this report, we examine the reasons for the failure to eradicate this disease from the community. (Am J Public Health 1982; 72: 1404-1406.) [ABSTRACT FROM AUTHOR]

Editorial. Comments on the increasing problem of tuberculosis (TB) in correctional institutions in the U.S. Transmission of TB infection within the facilities; Overrepresentation of population groups at high risk for TB in prisons and jails; Impact of TB in prisons on the communities into which inmates are released.

A letter to the editor is presented in response to the article tuberculosis in children.

Editorial. Presents opinion on the incidence of tuberculosis (TB) among migrant farm workers in the U.S. Number of migrant and seasonal farm workers as of April 1991; Association between years spent in migrant farm work and prevalence of TB infection among U.S.-born farm workers; Role of health departments.

A letter to the editor is presented in response to the article on the issues related to health manpower supply and demand of nurse practitioner.