Nemesis revisited: tuberculosis infection in a New York City men's shelter.

In November 1990, a screening was conducted to determine the point prevalence of tuberculosis infection in a volunteer sample of homeless men (n = 161) living in a congregate shelter in New York City. Of those for whom we have results (n = 134), 79% were positive for tuberculosis. The mean length of shelter stay from date of shelter entry was 31.8 months and was significantly associated with the tuberculosis infection rate. The findings suggest that crowded living conditions and the presence of a stable resident pool in crowded congregate shelters may be associated with transmission of tuberculosis infection.