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Tuberculosis on rise among AIDS victims, experts warn

Tuberculosis is spreading rapidly in the United States, particularly among people infected with the AIDS virus, and tough public health measures should be taken to stop what several federal officials described Saturday as a new epidemic. "We anticipate losing at least two decades of progress in tuberculosis control," said Dr. Sten Vermund of the National Institutes of Health in a news conference at the annual meeting of the American Association for the Advancement Science.

Tuberculosis rates throughout the country are rising sharply, but the impact is most striking in inner cities, with New York City leading the nation in tuberculosis cases, according to the Centers for Disease Control. In 1989, about 20,000 cases were reported nationally to federal officials _ roughly the same number as in 1960. In between, the number had dropped dramatically.

According to the Centers for Disease Control, at least half of the increase in tuberculosis cases is related to AIDS. People who are infected with the AIDS virus are particularly susceptible to all infections, including tuberculosis, which is a chronic lung infection.

"We should sound the alarm," Vermund said in an interview, noting that tuberculosis is spread easily when infected individuals cough. "I think we should worry about TB and the general public."

Vermund and a number of other officials from the National Institutes of Health and the Centers for Disease Control said cities with large AIDS epidemics should reinstitute the mandatory contact tracing policies for those diagnosed with tuberculosis. The policies were used two generations ago to bring TB under control. People were routinely tested for TB infection, and, if they carried the bacteria, were required to name all people they had contacted in recent weeks and might have exposed to the disease.

With proper antibiotic treatment TB is rarely lethal. But if acute case, it can lead to other lung disorders and pneumonia.

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