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

tic Standards and Classification of Tuberculosis”
(first so-named in 1920). The “Diagnostic
Standards” document continues to provide
important guidance to TB control efforts in
the US. The most recent revision has just been
completed.
In addition to the “Diagnostic Standards,” the
early ATS developed expert opinions, presented
in the form of committee reports, on
various clinical, research, and public health
aspects of TB. Obviously, because there was
no TB control agency within the federal
government until 1944, when the Division of
TB Control was established, these reports
were not collaborative ventures but were,
nevertheless, intended to guide the public
health aspects of TB. Although persons employed
in various federal agencies were members
of some of the committees, there was no
official USPHS representation (at least none
identified in published committee reports)
until 1943 when, in the “Report of the Committee
on Tuberculosis Sanatorium Standards,”
it was noted that a Dr. Sharp was
representing the USPHS. Additional involvement
of the ATS with the Division of Tuberculosis
Control was noted in the “Report of
the Committee on Postgraduate Medical
Education” in 1946. Dr. Herman Hilleboe, the
first director of the Division, requested suggestions
for the training of medical officers in TB
control and asked for the committee to review
courses that he had outlined.
In the same year the Committee on Rehabilitation
(of patients with TB) reported that the
USPHS, the NTA (and ATS), and the Federal
Office of Vocational Rehabilitation would
jointly provide a team to study rehabilitation
programs in the US. Also in 1946, the NTA
and ATS, together with the USPHS and the
American Hospital Association, developed an
informational package describing how hospitals
should conduct mass radiography screening
(“Report of Committee on Tuberculosis
Among Hospital Personnel”). These sorts of
collaborations continued on a more or less
TB Control at the Millennium
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informal basis through the 1950s and early
1960s. In the 1960s there were several instances
in which the ATS specifically endorsed
USPHS reports (the US Public Health Service
Task Force Report on Tuberculosis Control;
the USPHS Recommendations on the Use of
BCG Vaccine in the United States.)
It was not until 1971 that the first formally
acknowledged joint ATS/CDC statement was
published (Preventive Treatment of Tuberculosis:
A Joint Statement of the American
Thoracic Society, National Tuberculosis and
Respiratory Disease Association and the
Centers for Disease Control). Since that time
joint statements have also been published on
BCG vaccines (1975), eradication strategies
(1978), short-course chemotherapy (1980), TB
control (1983), treatment and prevention
(1986, 1994) and diagnostic standards and
classification of TB (1990). Currently, there
are three joint statements: “Diagnostic Standards
and Classification,” and “Targeted
Testing and Treatment of Latent Tuberculous
Infection,” both of which have been revised
recently, and the “Treatment of Tuberculosis”
that is now undergoing revision.
Although the historical and ongoing collaborations
between the ATS and the CDC are
exemplified most clearly by the formal joint
statements, the interactions go well beyond
these activities. Staff of the Division of Tuberculosis
Elimination are active and valued
members of the ATS, participating especially
in the programs of the Assembly on Microbiology,
Tuberculosis, and Pulmonary Infections,
and assuming leadership roles in many
of the Assembly’s undertakings. Likewise ATS
members, both as Society representatives and
as individuals, are regular participants in a
variety of CDC activities, including serving in
advisory roles, contributing to training
courses, and conducting program evaluations
(often organized by state ALAs).
It is striking to note the degree to which the
current collaborations of the ALA and the