What Is a Reportable Case of Tuberculosis?

Abstract

In one large American city, the reporting of cases of tuberculosis has been compulsory for more than half a century. Yet, despite this long history of experience in the field, about 40 percent of the tuberculosis deaths in the past 6 years were never reported as living cases of tuberculosis. And this is not alone the experience of this particular city. The American Public Health Association (1) reported in 1947 that in 66 communities 30 to 89 percent of the tuberculosis deaths were unreported as living cases. The current status of tuberculosis morbidity reporting in the United States is confused, shows uneven development from area to area, and, generally, leaves much to be desired. The usual experience of mass chest X-ray surveys, in which the majority of cases of tuberculosis are previously unknown to the health department concerned, is demonstrable proof of this. At the present time, general agreement can be reached aon only one point: that there is an abundance of disagreement-disagreement on objectives, on definitions, and on procedures. One of the greatest blocks to good reporting, for example, still remains the lack of any clear-cut definition of what may be considered a reportable case of tuberculosis; this, despite more than 30 years of almost universal compulsory reporting in the United States (2). Confusion still remains, too, on such basic questions as: Who should report? How should cases be reported? What reports should be counted? What types of medical diagnoses should be reported, and which of those reported should be counted? Head of Tuberculosis Control Section of Washington State Department of Health; medical director, and health program representative, Division of Tuberculosis, Public Health Serv!ce, respectively. This Is the forty-seond of7series of specalaissues of PUBIjC HEALTH RzPORTS devoted exclusively to tuberculosis control, which will appear in the flrst week of each month. The series began with the Mar. 1, 1946, issue. The articles in these special issues are reprinted as extracts from the PUBLIC HEALTH REPOTSs. Effective with the July 6, 1946, issue, these extracts may be purchased from the Superinten dent of Documents, Government Printing Office, Washington 25, D. C., for 10 cents a single copy

Epidemiology of Tuberculosis in the United States

“…Having a standard definition for a reportable case of TB for surveillance purposes became paramount [7], and in 1951, a committee consisting of state TB control officers and sanatoria directors published recommendations for TB case reporting and counting procedures [8]. In 1952, the United States Public Health Service (USPHS) Tuberculosis Control Program instituted procedures to report new cases of TB.…”

Reported Tuberculosis Morbidity: United States, 1949-1951

“…The ratio of new cases reported per death for each race varies from State to State (table 4) and from region to region, as is seen in the following summary The need for more uniformity in tuberculosis morbidity reporting has been described elsewhere (1) and in a preceding paragraph reference has been made to the new reporting recommendations adopted by the State tuberculosis control officers and sanatorium directors (2 November 1952 congratulated for their development of the new reporting recommendations. The application of these recommendations will provide each health department with more specific information regarding the number of people sick with tuberculosis who are just becoming known to the health department.…”