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Previous Volume 347:1453-1455 October 31, 2002 Number 18 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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To the Editor: According to the article by Geng et al. (May 9 issue),¹ the majority of cases of active tuberculosis in the New York City area are now reactivation cases in recently arrived immigrants. However, current guidelines advise chemoprophylaxis only in people 35 years of age or younger.² How should we use the current information³ in advising therapy for immigrants older than 35 who have a positive skin test with purified protein derivative, chest radiographs that show no abnormalities, and no evidence of underlying immune compromise?

Arthur W. Hammer, M.D.
Beth Israel Hospital
Brooklyn, NY 12234
arthurhdoc@hotmail.com

1. Geng E, Kreiswirth B, Driver C, et al. Changes in the transmission of tuberculosis in New York City from 1990 to 1999. N Engl J Med 2002;346:1453-1458. [Free Full Text]
2. Update: fatal and severe liver injuries associated with rifampin and pyrazinamide for latent tuberculosis infection, and revisions in American Thoracic Society/CDC recommendations -- United States, 2001. Am J Respir Crit Care Med 2001;164:1319-1320. [Free Full Text]
3. Targeted tuberculin testing and treatment of latent tuberculosis infection. Am J Respir Crit Care Med 2000;161:Suppl:S221-S247. [Free Full Text]

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