U.S. Tuberculosis Cases Hit Record Low, CDC Says

But minorities, those not born in the U.S. and HIV-positive patients still most likely to be affected

By Steven Reinberg
HealthDay Reporter

THURSDAY, March 24 (HealthDay News) -- Rates of tuberculosis fell to an all-time low in the United States in 2010, but the disease continues to disproportionately affect racial and ethnic minorities, those that are foreign-born, and people infected with HIV, federal officials reported Thursday.

There was a total of 11,181 tuberculosis (TB) cases reported in the United States in 2010, a 3.9 percent decline from 2009 -- to 3.6 cases per 100,000 people. Still, infection rates were seven times higher for Hispanics, eight times higher for blacks, and 25 times higher for Asians than for whites, the researchers found.

The study, released to coincide with World TB Day, also found that the TB rate was 11 times higher among those born outside the United States.

"That's 60 percent of the cases," said Dr. Kenneth G. Castro, director of the U.S. Centers for Disease Control and Prevention's Division of Tuberculosis Elimination. "This reflects the global nature of this public health problem," he noted.

"We continue to make progress against TB, however we didn't arrive at elimination as originally planned by 2010," he added.

Eliminating TB is defined as no more than one case per 1,000,000 people, Castro explained. "The rate we have now is 36 times higher than that," he said. When the elimination goal was set in 1989, the impact of HIV and drug-resistant tuberculosis weren't taken into account, he pointed out.

"Tuberculosis is a disease that preys on the poor in every society," Castro said. "People who are disadvantaged, especially in the United States, are underinsured or uninsured," he said.

Drug-resistant TB is a worldwide problem, Castro said, noting that about 1.3 percent of all cases are drug-resistant strains. In 2010, one case of extremely drug-resistant tuberculosis was reported to the CDC, noted the report, Trends in Tuberculosis -- United States, 2010, published in the March 25 issue of the CDC's Morbidity and Mortality Weekly Report.

For people with drug-resistant tuberculosis, it usually takes 18 months of treatment with drugs that are more toxic, less effective and more expensive than the drugs used to treat drug-sensitive TB, Castro explained. For regular TB, treatment usually lasts about six months, he noted.

Dr. Gordon Dickinson, chief of the Division of Infectious Diseases at the University of Miami Miller School of Medicine, called the record-low number of cases "good news," but added that "it's too bad it didn't achieve the CDC's goal."

Public health agencies have taken the lead in eliminating TB, Dickinson said, and he's concerned that cuts in public health funding could result in an increase in cases.

"This is good news. It demonstrates what good public health programs can do. But if TB programs are cut the trend will not continue -- it will reverse," he said.

In another study in the same issue of MMWR, researchers found that in two states, Georgia and Pennsylvania, there was an unexpected drop in TB cases in 2009. The reasons for the decline aren't clear, but they don't seem to be due to poor reporting or other procedural problems, the researchers said.

Tuberculosis is caused by germs spread through the air from person to person. It typically affects the lungs, but can also target other organs and body parts, such as the brain, the kidneys, or the spine. Left untreated, the disease can be fatal, according to the CDC.

Typical symptoms include feelings of sickness or weakness, weight loss, fever and night sweats. Symptoms of TB disease of the lungs also include coughing, chest pain, and the coughing up of blood, the agency said.

More information

To learn more about tuberculosis, visit the U.S. Centers for Disease Control and Prevention.

SOURCES: Kenneth G. Castro, M.D., director, Division of Tuberculosis Elimination, U.S. Centers for Disease Control and Prevention; Gordon Dickinson, M.D., chief of the Division of Infectious Diseases, University of Miami Miller School of Medicine; March 25, 2011, Morbidity and Mortality Weekly Report, U.S. Centers for Disease Control and Prevention

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