Special problems in tuberculosis. Tuberculosis in the elderly and in residents of nursing homes, correctional facilities, long-term care hospitals, mental hospitals, shelters for the homeless, and jails.

Now that tuberculosis is well controlled in most segments of our society, it is all too often forgotten as a disease that still plagues its less fortunate members. Thus, it may break out wherever persons are housed together for extended periods: for example, naval vessels (not discussed herein), nursing homes, prisons, jails, mental hospitals, chronic disease hospitals, juvenile detention facilities, and shelters for the homeless. It is the responsibility of the authorities operating any such facility to take the necessary precautions to prevent spread of tuberculous infection. This requires more than just keeping the facility clean; it requires the use of some technology--in this instance, in the form of performing tuberculin testing, taking chest radiographs of those who react positively, and treating appropriately those who are infected, whether they are already diseased or merely infected. It should not be forgotten that tuberculosis in any segment of the population endangers all citizens. If this disease is to be eliminated in America, special attention must be given to the segments of society in which both prevalence of infection and incidence of tuberculosis are still high. Probably the most efficient way to stop the spread of infection is through better control of the infection in institutions such as those described in this article.