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TB incidence declines in US, foreign-born carry highest burden
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The incidence of tuberculosis in the United States declined 4.2% from 2012, according to data from the CDC.
There were 9,588 new cases of TB in the United States in 2013, with an incidence rate of three cases per 100,000. Certain populations are disproportionately affected; specifically, foreign-born people accounted for 6,172 TB cases (64.6%). The incidence rate among this group in 2013 was 15.6 cases per 100,000 population. This is a 2.1% decrease since 2012, but still 13 times higher than the incidence rate of 1.2 cases per population among US-born people. More than half of the foreign-born cases were from Mexico, the Philippines, India, Vietnam or China.
“The majority of TB cases among foreign-born persons have been attributed to reactivation of TB infection acquired previously, with the rate reflecting TB incidence in their countries of origin,” the researchers wrote in MMWR. “Further interventions aimed at diagnosing and treating latent TB infection among foreign-born persons are necessary to meet the goal of TB elimination in the United States.”
TB incidence declined in all racial/ethnic groups, but the decline was greatest among whites (9.2%) and blacks (7.5%). The decrease among Hispanics was 5.3% and the decrease among Asians was 0.3%. The incidence rate among Asians was 18.7 cases per 100,000 people, 25.9 times higher than the incidence of 0.7 cases per 100,000 among whites.
In 2012, the most recent year for which data are available, there were 86 cases of multidrug-resistant TB. In 2012, the percentage of MDR-TB cases was 1.2%, a decrease from 1.6% in 2011. Foreign-born people accounted for 88.4% of the MDR-TB cases in 2012. There were two cases of extensively drug resistance reported in 2013 compared with two cases in 2012 and five cases in 2011.
Nine states had incidence rates higher than the national average: Alaska, California, Florida, Georgia, Hawaii, Nevada, New Jersey, New York and Texas. Four of these states — California, Texas, New York and Florida — accounted for 51.3% of all TB cases reported.
“The disparity between TB rates in different populations defined by factors such as geography, country of birth and housing status presents a challenge to TB control programs, given that strategies and interventions must be tailored to the population being served,” the researchers wrote. “Ongoing surveillance and an ability to translate surveillance data into public health action will be key to achieving TB elimination.”
Disclosure: The researchers report no relevant financial disclosures.
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