CDC History of Tuberculosis Control - Medical and Public Health ...

mented in selected age groups in the schools.
Review of immigrants coming to Alaska from
Southeast Asia and South America allowed
public health personnel to identify and treat
active disease, thus minimizing the spread of
TB into Alaska.
Effective treatment of TB has increasingly
required directly observed therapy, or DOT,
for successful management of the disease.
Many communities in Alaska have few tuberculin
reactors among school age children, but
there still remains a significant reservoir of
individuals who have had TB infection in the
past and who may potentially develop disease,
posing a challenge for public health. How to
identify new cases of TB at a time when
concern for the disease has diminished and
how to provide direct administration of
medication to infected individuals in remote
areas are continuing challenges.
As Alaska enters a new century, there is a
potential to eliminate TB from the population
and there is also the potential that the disease
will remain a chronic problem. The new
century will pose new challenges with diminished
public awareness of TB, and with HIV
infections in rural communities complicating
the problem.
CDC and the American Lung Association/
American Thoracic Society: an Enduring
Public/Private Partnership
by Fran DuMelle, MS
Deputy Managing Director, ALA
and Philip Hopewell, MD
Associate Dean, Univ of California, San Francisco
The origins of the American Lung Association
(ALA) and the American Thoracic Society
(ATS) and of their collaborations with the
CDC lie within the anti-TB movement of the
late 1800s and early 1900s. The potential value
of an organized voluntary society constituted
of both physician and lay members was recognized
in the late 1800s and marked by the
founding of the Pennsylvania Society for the
Notable Events in TB Control
23
Prevention of Tuberculosis in Philadelphia in
1892. Twelve years later, in 1904, under the
guidance of many of the luminaries of American
medicine at that time — Osler, Trudeau,
Welch, Janeway, Knopf — the National Association
for the Study and Prevention of Tuberculosis
(NASPT) was founded. Although the
NASPT was largely composed of physicians
and other health professionals (only two
laymen were included on its first 29-member
board of directors), its mission was public
education and public policy, not clinical care
or research.
In 1918 the NASPT changed its name to the
National Tuberculosis Association (NTA), a
name it retained for the next 50 years. Because
the organization was progressively involving
itself in a broader range of activities, in 1968,
after considerable discussion and debate, the
name was changed to the National Tuberculosis
and Respiratory Disease Association
(NTRDA). After being burdened with this
unwieldy name for 5 years, the NTRDA
became simply the American Lung Association
in 1973.
In 1905, a year after NASPT was chartered, a
subgroup — the American Sanatorium Association
(ASA) — was formed by physician
members of NASPT who, for the most part,
were directors of TB sanatoria. This group was
focused on the science of TB and on the
clinical care of patients with the disease.
Although comprising initially only sanatorium-based
physicians, the ASA subsequently
became more inclusive, with membership
open to all physicians and researchers in the
field. In 1939 the name of the ASA was