Mantoux testing of 7th graders in Tel Aviv, Israel.

As part of a countrywide program of tuberculin testing of 7th graders, 10,133 children were examined in the Tel Aviv area over the 3-year period, Septemer 1991-June 1994. Of these, 655 were from families recently arrived from the former Soviet Union (I), and 9478 from long-time resident families of Israel (L). Of the I group 537 had received BCG at least once (82.0%), of the L group 5306 (56.0%). In the nonvaccinated I group 33.9% had reactions of 10 mm or more (clinically significant) while the rate was 6.1% in the L group, a statistically highly significant difference. In the vaccinated I group the rate of clinically significant reactions was 49.3% as compared to 10.3% in the L group, also statistically a highly significant difference. In general, the clinically significant reactions were more commonly found in the I group as opposed to the L group. Both BCG vaccination and prior place of residence appear to be statistically significant independent variables. No cases of tuberculosis occurred among the entire population tested. These data provide a base for surveillance of tuberculosis risk in Tel Aviv specifically and Israel in general.

Epidemiology and control of tuberculosis in Israel.

OBJECTIVE: This review of the epidemiology and control of tuberculosis (TB) in Israel, covering the period from shortly before 1948 until the end of 1992 give a historical perspective to the TB situation and the various methods of control at different times. The effect of arrival in Israel of groups of immigrants from countries with a high prevalence of TB on the incidence in the host population is considered. DATA SOURCES: Data from unpublished reports and those published in Israel and abroad. Much data which was available form the Central TB Register of the Department of Epidemiology of the Ministry of Health was analyzed by the author during the time he was responsible for tuberculosis in Israel. Some of the data has been updated and presented here for the first time. RESULTS: With the mass immigration to Israel in the early 1950s, including many cases of active TB, there was a steep rise in the number of reported cases. Special services were developed. The TB rate dropped rapidly, and although there were later occasional peaks due to special immigrant groups, this did not appear to cause any serious increase in the TB incidence in the host population. CONCLUSIONS: TB control measures in Israel have passed through several phases and demonstrate the value of various methods which have to be changed according to the epidemiological situation.

Tuberculosis case finding and treatment in Ethiopian immigrants to Israel, 1989-91.

In addition to the immigrants from Ethiopia who arrived in Israel during the period 1980-90, a particularly large number immigrated in 1991 including a concentrated group (Operation Solomon). The procedures and problems involved in tuberculosis case-finding and treatment in Ethiopia and in Israel are described. The prevalence rate of cases of active tuberculosis in those who immigrated in 1991 was 1.3/100 persons as compared with 1.9/100 in the 1984-85 immigration (Operation Moses). Among the 1991 immigrants the number of cases reported was 261. In 89% the site was pulmonary. After screening and treatment in Israel there were very few cases of relapse or death and few contact cases in the host population. Follow-up of case reporting from 1983 is updated and demonstrates that the majority of cases are detected and treated within 2-3 years of immigration. Since 1980, 771 cases of tuberculosis were reported in all immigrants from Ethiopia.

Tuberculosis in Ethiopian immigrants.

The arrival in Israel of large numbers of immigrants from Ethiopia where there is a high prevalence of tuberculosis led to concern about the possibility of an increased incidence in Israel. A special screening and treatment program was instituted under the direction of the Ministry of Health together with surveillance of the epidemiological situation. During the 9-year period 1980-88, 394 cases of active tuberculosis (all forms) in these immigrants were notified, with a prevalence rate of 1.9/100. In 80% of the cases the disease was respiratory. Most cases were detected and treated soon after arrival and some within 2 years. There was no appreciable increase in the incidence rate in the population of the host country, 4.5/100,000 in 1988, which is one of the lowest in the world.

Standards for long-term care facilities in Israel.

Many long-term care facilities have been established in Israel over the years by different agencies and with varying levels in the quality of care. This paper considers the importance of written official standards and their relationship to supervisory procedures and presents a framework for the establishment of such standards.