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December 9, 1992

Correction Facility TB Rates Soar; Some Jails Bring Back Chest Roentgenograms

JAMA. 1992;268(22):3175-3176. doi:10.1001/jama.1992.03490220017003

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COOK COUNTY JAIL in Chicago, Ill, has reintroduced chest x-ray screening of inmates to control the spread of tuberculosis (TB), and this may signal a trend.

In any case, health care authorities at the Chicago correctional facility are recommending that other large jails and prisons, especially those whose populations come primarily from urban areas, return to chest x-ray screening to stop the current resurgence of TB (JAMA. 1992;268:174-175 and 1992;268:855-856; and JAMA. 1989;262:3249-3253).

Since 1985, there have been 11 known TB outbreaks in prisons in eight states. In one of these outbreaks, 13 inmates and one correctional officer died of multidrug-resistant TB.

These epidemics are occurring even where inmates are being screened on admission with purified protein derivative (PPD) tuberculin skin tests, as recommended by current Centers for Disease Control and Prevention (CDC, Atlanta, Ga) guidelines, says Michael Puisis, DO, acting medical director of Cermak Health Services, Chicago, a department