After 2 decades of progress toward tuberculosis (TB) elimination with annual decreases of ≥0.2 cases per 100,000 persons (1), TB incidence in the United States remained approximately 3.0 cases per 100,000 persons during 2013–2015. Preliminary data reported to the National Tuberculosis Surveillance System indicate that TB incidence among foreign-born persons in the United States (15.1 cases per 100,000) has remained approximately 13 times the incidence among U.S.-born persons (1.2 cases per 100,000). Resuming progress toward TB elimination in the United States will require intensification of efforts both in the United States and globally, including increasing U.S. efforts to detect and treat latent TB infection, strengthening systems to interrupt TB transmission in the United States and globally, accelerating reductions in TB globally, particularly in the countries of origin for most U.S. cases...
As they did during the previous 7 years, four states (California, Florida, New York, and Texas) reported >500 cases each in 2015 (Table 1). Together, these four states accounted for 4,839 TB cases, or approximately half (50.6%) of all reported cases. State-specific incidence ranged from 0.5 cases per 100,000 persons (West Virginia) to 9.1 TB cases per 100,000 persons (Alaska) (median state incidence = 2.0). By census division, the highest TB incidence was reported in the Middle Atlantic, West South Central, and Pacific divisions. The largest increases in TB incidence from 2014 to 2015 occurred in the East North Central, New England, Mountain, and West South Central divisions.
Among the 9,563 TB cases reported during 2015, 3,201 (33.5%) occurred among U.S.-born persons, corresponding to an annual TB incidence of 1.2 per 100,000 persons. The 6,335 TB cases among foreign-born persons in the United States (66.2% of the total U.S. cases) corresponded to an annual TB incidence of 15.1 per 100,000 persons (Table 2). Overall national TB incidence remained approximately 3.0 cases per 100,000 persons during 2013–2015 (Figure).
In 2015, most U.S.-born persons reported with TB were either non-Hispanic blacks (1,144 cases) or non-Hispanic whites (991 cases) (Table 2). Among U.S.-born non-Hispanic blacks, TB incidence was at an all-time low (3.3 cases per 100,000 persons). Incidence among U.S.-born non-Hispanic whites remained the lowest (0.5 cases per 100,000). Although U.S.-born Hispanics had the third highest case count (661 cases), they had the second lowest incidence (1.8 cases per 100,000). U.S.-born Native Hawaiians/other Pacific Islanders had the highest incidence (12.7 cases per 100,000), followed by U.S.-born American Indians/Alaska Natives (6.8 cases per 100,000). A total of 344 TB cases occurred among U.S.-born persons aged <15 years (0.6 cases per 100,000), representing 10.7% of all U.S.-born persons reported as having incident TB in 2015.
In 2015, among foreign-born persons with reported TB in the United States, Asians had both the highest case count (3,007 cases) and highest incidence (28.2 cases per 100,000 persons). The top five countries of origin for foreign-born persons with TB were Mexico (n = 1,250; 19.7%), the Philippines (n = 819; 12.9%), India (n = 578; 9.1%), Vietnam (n = 513; 8.1%), and China (n = 424; 6.7%). Together, these countries represent 45.2% of the foreign-born population in the United States (4), but accounted for 56.6% (3,584 cases) of all TB cases among foreign-born persons. Although Mexico-born persons accounted for the largest proportion of foreign-born persons reported with TB, their TB incidence in the United States (10.4 cases per 100,000) was lower than that among persons born in China (24.9 cases per 100,000), India (23.9 cases per 100,000), the Philippines (46.9 cases per 100,000), and Vietnam (47.8 cases per 100,000). From 2014 to 2015, the number of TB cases among Philippines-born persons grew from 755 to 819 (8.5% increase), and the number of TB cases among India-born persons grew from 479 to 578 (20.7% increase). The Philippines-born population in the United States grew from 1,639,286 to 1,747,287 (population growth of 6.6%), and the India-born population grew from 2,166,930 to 2,421,795 (population growth of 11.8%) (4). Ninety-six TB cases occurred among foreign-born persons aged <15 years (6.0 cases per 100,000), representing 1.5% of all foreign-born persons reported as having incident TB in the United States in 2015.
Below: Tuberculosis (TB) incidence overall and among U.S.- and foreign-born persons, by year — United States, 2000–2015
Full article at: http://goo.gl/yA6tZc
By: Jorge L. Salinas, MD1,2; Godwin Mindra, MBChB1,2; Maryam B. Haddad, MSN2; Robert Pratt2; Sandy F. Price2; Adam J. Langer, DVM2
1Epidemic Intelligence Service, CDC; 2Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC.
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