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

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500 200 100 50 20 10 5 2 1 0.5 Notable Events in TB Control A CENTURY OF ADVANCES IN TUBERCULOSIS CONTROL, UNITED STATES 1895 Roentgen discovers X-ray 41
Where We’ve Been and Where We’re Going: Perspectives from CDC Early History of the CDC TB Division, 1944 - 1985 by John Seggerson Associate Dir. for External Relations, DTBE In 1944, Congress passed the Public Health Service Act, which authorized grants to the states for TB control and established the “Division of Tuberculosis Control,” then located in Washington, DC. At the time of the creation of the TB Division, TB drugs were not available, and the primary method of TB control was the isolation of persons with active disease in TB sanatoria where they were “treated” with healthful living, bed rest, calorie-laden meals, fresh air, sunshine, and sometimes with surgery and/or collapsed lung therapy. PHS mobile x-ray unit From the beginning of the 20th century, the National Tuberculosis Association (later the American Lung Association), and its state and local affiliates, played a major role in establishing and supporting the TB sanatorium movement in the US. During the post-WW II period and into the 1950s, TB associations and health departments employed small-film x-ray units to conduct TB screening in general populations, with one x-ray unit often screening as many as 500 persons per day. The TB Control at the Millennium 42 screening did not effectively cover large city populations and by 1947, the PHS Division of TB Control was operating mobile x-ray unit teams in some 20 cities of more than 100,000 population which participated in this PHS big city program. By 1953, after some 20 million people had been x-rayed for TB, the program was discontinued owing to declining yield and high cost. Many health department and TB association community x-ray screening programs were also discontinued, although some continued until the late 1960s. In 1959, a group of nationally recognized TB experts was convened in Harriman, New York, to review the status of US TB control, and they issued the “Arden House Report,” which recommended the eradication of TB with effective treatment programs to cure disease and prevent spread. The Arden House group also recommended isoniazid treatment of latent TB infection based on extensive PHS chemoprophylaxis trials. In late 1960, the PHS TB program, by then renamed the “Tuberculosis Branch,” was transferred from Washington, DC, to Atlanta, to what was then called the Communicable Disease Center. The TB research activity remained in Washington for the time being, then was also transferred to Atlanta in the early 1970s. In the 1960s it became increasingly obvious that long-term hospitalization of patients with active TB was no longer necessary because of the availability of effective chemotherapy, and the TB Branch began to advocate that patients receive most or all of their care on an outpatient basis. The sanatoria began to close, with most of them being closed by the end of the 1970s. It has been estimated that the closing of the sanatoria represented a savings of more than $400 million to state and local governments. In 1963, in response to a special Surgeon General’s Task Force report on TB, categori-
Page 1 and 2: Christmas Seal Campaign, 1945. Reco
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Page 5 and 6: was clearly evident in the literatu
Page 7 and 8: grams that was emulated by other he
Page 9 and 10: In 1947, the PHS organized and supp
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Page 19 and 20: At first some of the nursing staff
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Page 25 and 26: on preventive therapy. In addition,
Page 27 and 28: changed to the American Trudeau Soc
Page 29 and 30: tic Standards and Classification of
Page 31 and 32: For several years many in the TB co
Page 33 and 34: through training. In 1993, the CDC
Page 35 and 36: New Jersey Medical School National
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Page 47 and 48: working as a team with state and lo
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Page 53 and 54: TB; and d) there was also a suggest
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Page 57 and 58: therapy for pulmonary TB. Enrollmen
Page 59 and 60: ehavioral science and implementatio
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