Recent increases in TB cases reported in geographic areas and demographic populations with large numbers of AIDS cases suggest a strong association between the HIV epidemic and the increased TB morbidity. Outbreaks and Transmission Sites Recently, several outbreaks of multidrug-resistant TB have occurred in hospitals and correctional facilities. Most of the cases in these outbreaks were caused by strains of M. tuberculosis resistant to isoniazid and rifampin, the two best TB drugs. Moreover, most of the patients involved in these outbreaks were HIV-infected persons. The morality rates were high, and multidrug-resistant TB was transmitted to health care workers.
Some correctional facilities have a large problem with TB transmission.
A CDC study conducted in 1984 and 1985 showed that there were four times as many TB cases in persons living in correctional facilities as there were in persons of the same age living outside correctional facilities. In a 29-state survey conducted in 1984 and 1985, the CDC found that the rate of TB disease was twice as high for elderly persons living in nursing homes as for elderly persons not living in nursing homes. Transmission continues to occur in the community at large. TB case rates are increasing for children younger than 15 years of age, especially for children younger than 5 years of age.