In 1994 the Centers for Disease Control and Prevention (CDC) published guidelines for preventing the transmission of Mycobacterium tuberculosis in healthcare facilities. These guidelines were issued in response to a number of factors, including a resurgence of tuberculosis (TB) that occurred in the United States in the mid-1980s and early 1990s, and the appearance and transmission of multidrug-resistant (MDR) TB strains. The guidelines were implemented widely in healthcare facilities nationwide. As a result, a decrease has occurred in the number of TB outbreaks in healthcare settings reported to CDC, and a decrease in healthcare-associated transmission of M. tuberculosis to patients and healthcare workers was also reported. Concur-rently, the upsurge in reported cases of TB was reversed, and case rates have declined in subsequent years. However, TB rates higher than the US average continue to be reported in certain racial/ethnic populations. Despite the general decline in TB rates in recent years, a marked geographic variation in TB case rates persists, meaning that healthcare workers in different areas face different risks. For example, in 2004 case rates per 100,000 population were 1.0 in Wyoming; 7.1 in New York; 8.3 in California, and 14.6 in the District of Columbia.
(Source: Morbidity and Mortality Weekly Report, Centers for Disease Control and Prevention, December 30, 2005)
