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October 16, 1996

Tuberculosis in New York City: Focal Transmission of an Often Fatal Disease

Author Affiliations

From the Department of Medicine, the Cambridge (Mass) Hospital, Harvard Medical School, and the Massachusetts Department of Public Health, State Laboratory Institute, Boston, Mass (Dr Nardell); and the Department of Community Medicine, St Vincent's Hospital and Medical Center, New York, NY (Dr Brickner).

JAMA. 1996;276(15):1259-1260. doi:10.1001/jama.1996.03540150061032

Forty-four percent of a cohort of mostly young adults with tuberculosis died within 31/2 years of diagnosis. This high mortality figure comes not from sub-Saharan Africa, nor 19th century America, but from New York City in the late 20th century. Two thirds of another cohort of patients, most infected with the human immunodeficiency virus (HIV), became coinfected with tuberculosis resistant to almost all antibiotics (multidrug-resistant tuberculosis) in the very hospitals where they sought medical care. Over a 43-month period early in the current resurgence, transmission in just 4 hospitals was apparently responsible for most of the multidrug-resistant tuberculosis in New York City, which at the time accounted for approximately 1 in 4 of all multidrug-resistant tuberculosis cases in the United States. These are some of the important findings of 2 retrospective studies published in this issue of The Journal.1,2

See also pp 1223 and 1229.

Although the tuberculosis epidemic