Tuberculosis and Migrant Farm Workers

No reliable figure is available for the number of migrant farm workers and their family members in the United States, but estimates developed by the Migrant Health Program 1 indicate that there may be between 3 and 5 million migrant and seasonal farm workers. And no system is in place to measure the magnitude of the tuberculosis (TB) problem in this highly mobile population, but in a 1984 to 1985 Centers for Disease Control survey of TB cases reported in 29 states, farm laborers accounted for more than 5% of all employed cases (Centers for Disease Control, unpublished data, December 1987). In this issue of JAMA , Ciesielski et al 2 report a population-based study of TB in a random sample of migrant farm workers conducted in 1988 in North Carolina. There were several significant findings from this study, but the most striking was the discovery of active TB in 0.47%