Tuberculosis: is the past once again prologue?

Tuberculosis has been considered the result of hereditary susceptibility, miasmas in the environment, and contact with contagious patients. During most of the latter half of this century, tuberculosis control efforts have concentrated almost exclusively on contagion by treating patients to make them noninfectious, treating latent tuberculosis to prevent reactivation, and in some countries, vaccinating uninfected persons to protect them from the consequences of infection. With the resurgence of tuberculosis in 1985, interest in all methods of tuberculosis control has been rekindled. Much remains to be discovered and much needs to be done. If renewed efforts succeed in again forcing tuberculosis rates downward, will we have the wisdom to eliminate tuberculosis in the United States, or will we relax and bring about another resurgence?