Tuberculosis among foreign-born persons entering the United States. Recommendations of the Advisory Committee for Elimination of Tuberculosis.

In 1989, the Department of Health and Human Services Advisory Committee for Elimination of Tuberculosis published a plan for eliminating tuberculosis from the United States by the year 2010. This plan gives a top priority to implementing strategies to prevent tuberculosis in high-incidence groups. Foreign-born persons (as a group) residing in the United States have higher rates of tuberculosis than persons born in the United States. In 1989, the overall U.S. tuberculosis rate was 9.5 per 100,000 population; for foreign-born persons arriving in the United States, the estimated case rate was 124 per 100,000. In the period 1986-1989, 22% (20,316) of all reported cases of tuberculosis occurred in the foreign-born population. A majority of foreign-born persons who develop tuberculosis do so within the first 5 years after they enter the United States. The ACET recommends that all foreign-born persons applying for permanent entry into the United States continue to be screened for disease. Deficiencies in the current screening methods should be corrected. The policy requiring that persons found to have infectious tuberculosis (known or suspected) be prevented from entering the country until treatment has rendered them noninfectious should be continued; however, persons with noninfectious tuberculosis should be permitted to enter the United States. Tuberculin skin testing and preventive therapy programs for foreign-born persons must be expanded both overseas and domestically if the goal of eliminating tuberculosis from the United States by the year 2010 is to be met.