U.N. Agency Sees Alarming Resurgence of Tuberculosis : Health: Report blames public complacency and increased world travel. It sees threat of ‘catastrophe’ for the industrialized world.

Public complacency and the ease of international travel have led to a resurgence of tuberculosis in the industrialized world that is threatening to become “a health catastrophe,” a U.N. agency has concluded.

The World Health Organization, in an annual report on the disease to be released today, said that “most people in Europe and North America have been watching other crises”--including AIDS--while tuberculosis has become “the world’s most neglected health crisis.”

In an advance copy of the report obtained by The Times, the U.N. agency concluded that “TB has returned to the industrial world with a vengeance in new and even deadlier forms.”

Tuberculosis, an often fatal disease of the respiratory tract characterized by fever and weight loss, is one of the oldest diseases known to man. It is turning up “sometimes in a pernicious, multi-drug-resistant form that is harder and more expensive to treat,” the organization said, adding that “AIDS has certainly facilitated its spread because it destroys the cells which keep the TB bacteria dormant.”

The return of TB to wealthier nations is particularly disheartening, according to the report, because most people assumed it had been wiped out in the 1950s.

“In reality, while TB was virtually eliminated in industrialized countries, nothing changed in the developing world,” the report said. “Tens of millions of people have been dying from TB for decades. Each year it kills more than 3 million people . . . more than all the adult deaths from all other infectious diseases combined, including AIDS.”

The report said TB had been declining in the United States at a rate of 6% a year until 1985, when it began to rise again. Nationwide nearly 15 million people are now infected with TB.

Aside from public complacency, which has resulted in inadequate resources to combat TB, the agency attributed the disease’s resurgence to increased world travel and to a rise in immigration to the United States and Europe.

“Twenty-seven percent of all new cases in the United States last year were in victims who had recently come from another country,” the report said. “There is no control of TB in the industrialized world unless it is sharply reduced in Africa, Asia and Latin America.”

The study added that “an increase in TB funding and change in direction is the only way to avert a health catastrophe.”

The report said the United States and other U.N. member nations must support “more effective TB treatment programs in every region of the world,” a goal the organization said could be met by spending only $22 million over a two-year period.

The report, to be released at a news conference in Washington, comes in the wake of a congressional report last month that said the highly contagious disease has increased 20% in the United States since 1985.

That report by the U.S. Office of Technology Assessment said that the Clinton Administration and the last two Republican administrations had all failed to seek funds needed to curtail the epidemic.

The WHO report said that in this country, the most serious tubercular problems have occurred in New York City and Atlanta in recent years.

It cited Los Angeles County as a jurisdiction that spends $23 million annually on TB prevention and control--more than all U.N. members contribute to WHO’s global control efforts.

In Los Angeles County last year, an estimated 26 of every 100,000 residents were diagnosed with TB--a rate 2 1/2 times the national average. Doctors report a troubling rise in cases among African-Americans and children, and they express concern that outbreaks of drug-resistant TB, which have swept through New York City jails and hospitals, could hit Los Angeles if more was not done to prevent the spread of the disease.

At the same time, county officials have come under criticism for failing to do enough to control TB. A blue-ribbon panel of experts recently faulted top managers at the county Department of Health for bungling the management of $1 million in federal TB money. The panel complained that of the $23 million the county spent on TB last year, less than 10% was spent on prevention.

Times medical writer Sheryl Stolberg in Los Angeles contributed to this story.