Guidelines for preventing the transmission of tuberculosis: a better solution?

The incidences of tuberculosis in general and of drug-resistant tuberculosis in particular have increased significantly since 1985 in the United States. The proposed revision of the 1990 guidelines for preventing the transmission of tuberculosis by the Centers for Disease Control and Prevention will be tremendously expensive. A better solution might consist of the implementation of a graded-response strategy depending on the magnitude of the problem posed by tuberculosis in a particular area, reeducation in and strict adherence to the basic principles of infection control, and the investigation of various masks and respirators to determine which are cost-effective.