More aggressive treatment of latent tuberculosis infections in non-U.S.-born residents in New York City could reduce the very high rate of the active disease in this population, according to an analysis of the disease during the last decade by researchers at Columbia Universitys College of Physicians & Surgeons and Mailman School of Public Health, the Public Health Research Institute, and the New York City Department of Health Tuberculosis Control Program.

The findings, which will be published in the May 9 New England Journal of Medicine, suggest current public health strategies that target only active infections will not reduce TB in non-U.S.-born residents in New York. The results also point to the need for better international tuberculosis control.

The data show that if we want tuberculosis to go down further, we need a different strategy that includes more treatment of latent infection in those arriving in New York from countries in which TB is common, says senior author Dr. Neil Schluger, associate professor of medicine at P&S and environmental health sciences at the Mailman School of Public Health, and clinical chief of the Division of Pulmonary, Allergy, and Critical Care Medicine at Columbia Presbyterian Medical Center.

Although the findings deal with results from New York City, we should be considering treating latent infections in recently arrived immigrants throughout the country. But the only way, however, to get at the root of the TB would be to better fight the bacterium throughout the world.

Tuberculosis is caused by the Mycobacterium tuberculosis bacterium, a slow-growing microbe that infects the lungs. People acquire the bacteria by inhalation and most of the time, the infection remains latent, never causes any symptoms, and is not contagious. In 10 percent of people, though, the latent bacteria event
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Contact: Annie Bayne
as862@columbia.edu
Columbia University Medical Center
21-May-2002