Half of U.S. TB cases in four States
July 1, 2012 2 minutes read
Half of U.S. TB cases in four States
Source: Centers for Disease Control and Prevention. Trends in Tuberculosis – United States, 2012. MMWR 2012; 61: 181-185.
National data available for 2011 indicate that a total of 10,521 new TB cases were reported last year in the United States (incidence 3.4 cases/100,000 population), representing an overall decline of 3.8% from 2010. TB continues to disproportionately affect foreign born persons, and Asians became the single largest racial/ethnic group affected by TB, with a case rate 25 times higher than non-Hispanic whites. TB cases among Hispanics and non-Hispanic blacks fell slightly, but remained 7 and 8 times higher than non-Hispanic whites, respectively.
Remarkably, half (50.4%) of all TB cases in the United States occurred in 4 States in 2011 (California, Florida, New York, and Texas), although the case rate per population was the highest for Alaska (case rate 9.3 per 100,000 population).
Since 2000, a steady increase in TB has been observed in foreign born persons, with 62.5% of all TB cases in 2011 occurring in those who are foreign born. In contrast, cases in U.S.-born persons declined to a rate of 1.5 cases/100,000 population – an 80% decrease from 2003.
HIV test results were available for 81% of reported cases; among those with an available HIV test result, 7.9% were co-infected with TB and HIV.
Finally, drug resistance data (which was only available for 2010 and not yet available for 2011) indicates that 1.3% of all cases were multi-drug resistant. This figure is relatively stable compared with 2009. A total of 109 cases of MDR-TB and 4 cases of XDR-TB (all in foreign-born individuals) were reported in 2010. The risk for MDR-TB was four times greater in persons previously treated for TB compared with those receiving first time therapy.
Programs targeting high risk ethnic groups have been associated with a lower risk of reactivation TB. For example, one program targeting predominantly black and Hispanic neighborhoods in Texas, emphasizing INH treatment for anyone with latent TB, resulted in a definite decrease in active TB cases. Perhaps larger clinics in certain high risk areas of the United States, like Sutter Health and the Kaiser Permanente systems could consider similar programs.
National data available for 2011 indicate that a total of 10,521 new TB cases were reported last year in the United States (incidence 3.4 cases/100,000 population), representing an overall decline of 3.8% from 2010.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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