J Infect Dis. 1994 Jul;170(1):151-6. Unique Identifier : AIDSLINE
Three epidemiologically linked multidrug-resistant (MDR) tuberculosis
(TB) outbreaks in 1990-1991 involving New York State (NYS) inmates
suggested MDR-TB was widespread in NYS prisons. Inmate lists were linked
to 1990-1992 TB registries, medical records were reviewed, and movement
histories for inmates with MDR-TB were examined within and between
prisons and hospitals. In 1990-1991, 171 inmates were diagnosed with TB.
This rate (156.2/100,000) was significantly higher than the 1990-1991 US
rate (10.4/100,000) and the 1986 rate among NYS inmates (105.5/100,000).
Of 171 cases, 155 were cultured-confirmed; 37 (32%) of 116 with drug
susceptibilities determined had MDR-TB. Two other inmates with TB before
1990 were diagnosed with MDR-TB in 1990-1991. Of 39 inmates with MDR-TB,
38 (97%) were infected with the human immunodeficiency virus and 34
(87%) have died. These 39 lived in 23 of the 68 NYS prisons while
potentially infectious; 12 were transferred through 20 prisons while ill
with MDR-TB. Policies of correctional systems on infection control and
inmate transfers need to be reevaluated to prevent spread of TB.
Adult Case-Control Studies *Disease Outbreaks Female Follow-Up
Studies Human Male New York/EPIDEMIOLOGY *Prisons Retrospective
Studies Tuberculosis, Multidrug-Resistant/*EPIDEMIOLOGY JOURNAL