MMWR Morb Mortal Wkly Rep. 2016 Mar 25;65(11):279-81. doi: 10.15585/mmwr.mm6511a3.
Tuberculosis (TB) is a contagious bacterial disease of global concern. During 2013, an estimated nine million incident TB cases occurred worldwide (1). The majority (82%) were diagnosed in 22 countries, including South Africa and the Philippines, where annual incidence was 860 TB cases per 100,000 persons and 292 TB cases per 100,000 persons, respectively (1). The 2013 TB incidence in the United States was three cases per 100,000 persons (2). Under the Immigration and Nationality Act, TB screening is required for persons seeking permanent residence in the United States (i.e., immigrants and refugees), but it is not routinely required for nonimmigrants who are issued temporary visas for school or work (3). A portion of the U.S. tourism industry relies on temporary visa holders to accommodate seasonal and fluctuating demand for service personnel (4). This report describes three foreign-born persons holding temporary visas who had infectious TB while working at tourist destinations in the United States during 2012-2014. Multiple factors, including dormitory-style housing, transient work patterns, and diagnostic delays might have contributed to increased opportunity for TB transmission. Clinicians in seasonally driven tourist destinations should be aware of the potential for imported TB disease in foreign-born seasonal workers and promptly report suspected cases to health officials.
肺结核（TB）是一种具有全球影响的传染性细菌性疾病。2013 年，全球估计有 900 万例新发病例（1）。大多数（82%）病例发生在 22 个国家，包括南非和菲律宾，其年发病率分别为每 10 万人 860 例和 292 例（1）。美国 2013 年的肺结核发病率为每 10 万人 3 例（2）。根据《移民和国籍法》，寻求在美国永久居留的人（即移民和难民）需要进行肺结核筛查，但对于持临时签证来美上学或工作的非移民则不要求常规筛查（3）。美国部分旅游业依赖临时签证持有者来满足季节性和波动的服务人员需求（4）。本报告描述了 2012-2014 年期间在美国旅游目的地工作的 3 名持临时签证的外国出生者，他们患有传染性肺结核。多种因素，包括宿舍式住房、临时工作模式和诊断延迟，可能增加了肺结核传播的机会。季节性旅游目的地的临床医生应该意识到外国出生的季节性工人中可能存在输入性肺结核病，并及时向卫生官员报告疑似病例。
