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Response from the Authors

      We would like to clarify some specific scientific and military issues raised by Dr. Nevin's response to our article.
      • Mancuso J.D.
      • Tobler S.K.
      • Eick A.A.
      • Keep L.W.
      Active tuberculosis and recent overseas deployment in the U.S. military.
      These issues include the thesis that switching from the use of the tuberculin skin test (TST) to an interferon-gamma release assay (IGRA) will improve adherence to therapy in the military's universal latent tuberculosis infection (LTBI) screening program and the thesis that the IGRA would be more cost effective than the TST in military populations.
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      References

        • Mancuso J.D.
        • Tobler S.K.
        • Eick A.A.
        • Keep L.W.
        Active tuberculosis and recent overseas deployment in the U.S. military.
        Am J Prev Med. 2010; 39: 157-163
        • Rust P.
        • Thomas J.
        A method for estimating the prevalence of tuberculosis infection.
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        • Mazurek G.H.
        • Zajdowicz M.J.
        • Hankinson A.L.
        • et al.
        Detection of Mycobacterium tuberculosis infection in United States Navy recruits using the tuberculin skin test or whole-blood interferon-gamma release assays.
        Clin Infect Dis. 2007; 45: 826-836
        • Mancuso J.D.
        • Tobler S.K.
        • Eick A.A.
        • Olsen C.H.
        An evaluation of the completeness and accuracy of active tuberculosis reporting in the United States Military.
        Int J Tuberc Lung Dis. 2010; (in press)
        • CDC
        Targeted tuberculin testing and treatment of latent tuberculosis infection.
        MMWR Recomm Rep. 2000; 49: 1-51

      Linked Article

      • Active Tuberculosis and Recent Overseas Deployment in the U.S. Military
        American Journal of Preventive MedicineVol. 39Issue 6
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          In their recent analysis1 of tuberculosis within the U.S. military, Mancuso and colleagues demonstrate that factors identifiable at application comprise the strongest risk for subsequent development of active tuberculosis. Their findings imply that a significant burden of disease within the U.S. military is due to pre-existing latent tuberculosis infection (LTBI) among new recruits.
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