Over the past 20 years, when the United States has seen substantial tuberculosis outbreaks, they have frequently originated in homeless shelters in cities such as Atlanta, Jacksonville, Los Angeles, and Seattle. Although such outbreaks have fortunately been contained through immediate implementation of surveillance measures, the lack of dedicated policies on treating homeless people with latent tuberculosis infection means that there's a high risk of recurrence.

The Centers for Disease Control and Prevention advocates targeted screening and treatment of latent tuberculosis infection in high-risk populations, which include close contacts of people with active tuberculosis, immigrants from regions where tuberculosis is endemic, homeless people, and those with immunosuppression.