U.S. TB rates reach record low

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U.S. tuberculosis rates reached an all time low this year with 11,181 cases reported in 2010 – the equivalent of 3.6 cases per 100,000 population, according to a CDC report, but more work is still necessary to eliminate the disease.

“Continued progress in meeting the goal of TB elimination will hinge on improving TB control and prevention activities among disproportionately affected populations, including foreign-born persons, blacks and Hispanics,” CDC investigators wrote in the March 25 issues of Morbidity and Mortality Weekly Report, which was released to coincide with World TB Day.

TB rates among foreign-born residents of the United States were 11 times greater than those recorded among U.S.-borne individuals, surveillance data indicated, and rates of new cases were disproportionately high among certain racial and ethnic groups.

New TB cases occurred at a rate of 1.6 per 100,000 among U.S.-borne individuals vs. 18.1 per 100,000 among foreign-born individuals. Almost half of these new cases came from just four states – California, Florida, New York and Texas – and varied as follows by race and ethnicity:

  • Whites – 0.9 per 100,000
  • Hispanics – 6.5 per 100,000
  • Blacks – 7.0 per 100,000
  • Asians – 22.5 per 100,000

Similarly, nearly half of new TB cases that occurred in foreign-born people originated in just four countries — India, Mexico, the Philippines and Vietnam — occurring most frequently in Asians (95%), followed by Hispanics (75%), blacks (34%) and whites (20%).

Overall, U.S. TB rates declined by 3.9% in 2010 — similar to the 3.8% reduction observed in 2000 to 2008, but much lower than the record 11.4% decline observed in 2009. Investigators believe the 2009 rates were an “abberation,” that likely reflected “changing migration patterns,” as declines in TB case rates among foreign born individuals were also more substantial that year.

Investigators called for the development of “better diagnostic tests and screening strategies for persons with latent TB infection, shorter treatment regimens, a new and effective vaccine and improvements in global TB control,” to reach the national TB elimination goal of <0.1 cases per 100,000 population.

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