The incidence of new tuberculosis cases in the United States in 2014 decreased 2.2% from 2013, but is the smallest decline in more than a decade, according to new data.
“Despite the continued decline in U.S. TB cases and rates since 1993, the 2.2% decrease from 2013 to 2014 to a rate of 3.0 per 100,000 still does not achieve the goal of TB elimination (1 case per 1,000,000) set in 1989 and reaffirmed in 1999,” the researchers wrote in MMWR. “Continued progress toward TB elimination in the United States will require ongoing surveillance and improved TB control in groups at high risk, especially racial/ethnic minorities.”
Researchers from the CDC’s Epidemic Intelligence Service and the Division of Tuberculosis Elimination evaluated 2014 data from the CDC’s National Tuberculosis Surveillance System. There were 9,412 new cases of TB reported in 2014, corresponding with an incidence rate of 2.95 per 100,000. This was a 2.2% decrease from the 2013 incidence rate of 3.02 per 100,000.
The rate decreased by 6.3% among U.S.-born people and by 1.5% among foreign-born people. However, the rate of TB among foreign-born people was 13.4 times higher than the rate among U.S.-born people: 15.3 vs. 1.1 per 100,000. Foreign-born individuals comprised 66.5% of the TB cases with a known national origin. More than half (55.3%) of the foreign-born people with TB originated from Mexico, the Philippines, Vietnam, India and China.
The rate of TB among Asians was 28.5 times greater than that of non-Hispanic whites. However, the rate declined from 18.6 per 100,000 to 17.9 per 100,000. The rate among non-Hispanic blacks and Hispanics was eight times higher than that of non-Hispanic whites. California, Texas, New York and Florida accounted for half of all cases. The rate of multidrug-resistant cases of TB remained stable.
“Alignment of domestic TB control activities with international control initiatives is needed to address increasing disparities in TB rates between U.S.-born and foreign-born persons,” the researchers wrote. “Focused treatment of [latent TB infection] also is needed to prevent TB in all groups at high risk.” – by Emily Shafer
Disclosure: The researchers report no relevant financial disclosures.