Tuberculosis epidemic in Amerikan prisons The February issue of the Annals of Epidemiology reported that 20.1% of all Texas prisoners were infected with the bacterium which causes tuberculosis.(1) About 10% of people infected with the M. tuberculosis bacterium will eventually develop active TB; people infected with both HIV and M. tuberculosis are at a much higher risk of developing TB.(2) From these figures, we estimate that the yearly incidence of active TB among Texas prisoners is 56 per 100,000.(3) This is 4.7 times the rate in the general population in Texas and 6.5 times the rate in the united $tates as a whole.(4) TB infection was by far the most prevalent disease among Texas prisoners. The Texas prison system is not the only system with elevated TB incidence. The rate in New York prisons was more than six times the rate for the general New York population. In one California prison, the rate was 10 times the statewide rate. The higher incidence among prisoners may be due to two factors. First, there may be higher transmission rates in prison. Second, prisoners come disproportionately from oppressed groups, which have higher TB rates on the outside as well. TB is highly contagious, especially in cramped quarters. Some studies have shown a correlation between length of incarceration and latent TB infection, suggesting that transmission occurs within prisons.(1) In California, several TB outbreaks have been documented. Two TB patients passed the infection on to 29 other prisoners -- nine of whom were paroled, not knowing they had contracted the disease.(7) So Amerika's prisons also may play a role in spreading TB among the oppressed within u.$. borders. TB (a.k.a. "consumption") is a potentially fatal disease which causes lack of energy, weight loss, and persistent cough. People with TB may begin to cough up blood as the disease erodes their lungs. TB was the leading cause of death in the capitalist countries in the 19th century and early 20th century. Poverty and crowded and unsanitary living conditions contribute to the spread of the disease. TB is one of the reasons Marxists speak about the "absolute immiseration" of the masses. It is still a big killer in the growing urban areas in the Third World -- especially Africa and Asia. Although the incidence of TB declined greatly during the 20th century in affluent imperialist countries like the United States, it rebounded in the last 20 years, largely because of increases in homelessness, incarceration, immigration, and HIV infection. According to the Centers for Disease Control, 70% of all TB cases occur in "racial/ethnic minorities" -- 86% of TB cases among children younger than 15 occur in "racial/ethnic minorities."(5) Estimates of the prevalence of latent TB infection among homeless people in the united $tates range as high as 51%.(6) About 33% of the population of the Third World are infected with TB bacteria. The medical knowledge and resources to control TB and many other big killer diseases exist. What is lacking is the political will to treat the oppressed or invest in appropriate preventative measures. This is because under capitalism, resources are allocated according to profit, not humyn needs. Thus a TB epidemic rages in the Third World and oppressed groups inside u.$. borders, while billions are spent on Viagra and plastic surgery. Only under socialism -- where the masses make sure that survival rights come before profits -- can the health needs of the oppressed be addressed. Notes: 1. Baillargeon J, et al, "The Disease Profile of Texas Prison Inmates," Annals of Epidemiology, Feb 2000, pp. 74-80. 2. CDC, "Prevention and control of tuberculosis in correctional facilities," MMWR-RR, 7 June 1996. 3. Incidence in people infected with both HIV and M. tuberculosis: 8%. Estimated yearly incidence among people infected with M tuberculosis alone (to give 10% cumulative risk by age 65): 0.16%. The (very low) estimate of HIV/AIDS prevalence in TX prisons given in the "Annals" article: 1.6%. Estimated yearly incidence in TX prisons: (Proportion with M tuberculosis alone )*(incidence) + (Proportion with M tuberculosis and HIV)*(incidence) = (0.198)*(0.0016) + (0.003)*(0.08) = 56 per 100,000. 4. CDC, "Tuberculosis Morbidity -- United States, 1995," MMWR, 10 May 1996, pp. 365-370. Department of Commerce, Statistical Abstract of the United States, 1996. 5. CDC, "Prevention and control of tuberculosis in U.S. communities with at-risk minority populations," MMWR-RR, 17 April 1992. 6. CDC, "Prevention and control of tuberculosis among homeless persons," MMWR-RR, 17 April 1992. 7. CDC, "Tuberculosis outbreaks in prison housing units for HIV- infected inmates -- California 1995-1996," MMWR, 5 February 1999, pp. 79-82.