We welcome the comments of Dr Bayuk and Dr Fleenor and Ms Curtis. Prior to their arrival in the United States, applicants for immigrant and refugee status are screened for active TB; chest radiographic examinations are required for all persons 15 years of age or older. Individuals with abnormal chest radiographs must submit sputum samples for acid-fast bacillus examination. If classified as noninfectious (negative sputum for acid-fast bacillus), persons with possible evidence of TB are permitted entrance to the United States, but are given a notification and must report to the local health department for further evaluation soon after arrival. Because of the high prevalence of active TB among persons with such notifications,1local health departments should ensure that this group is promptly assessed. In addition, health departments should identify persons from countries with a high prevalence of TB to assess for latent TB infection and provide. © 1995, JAMA. All rights reserved.

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