By incarcerating drug users, the Nation is putting people at high risk of HIV infection and TB into enormously crowded facilities that cannot safely house people with contagious respiratory diseases. People infected with HIV and TB are at enormous risk for developing active TB. Overtaxed medical staffs at correctional facilities are not able to detect and track all inmates with active TB. Cook County Jail in Chicago, Ill., has reintroduced chest x-ray screening of inmates to control the spread of tuberculosis, and this may signal a trend. Health care authorities at the Chicago correctional facility are recommending that other large jails and prisons, especially those whose populations come primarily from urban areas, return to chest x-ray screening to stop the current resurgence of TB.