Tuberculosis Cases Increase in U.S. for the First Time in 23 Years

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The number of tuberculosis cases in the United States rose last year for the first time in almost a quarter century, the Centers for Disease Control and Prevention reported Thursday (March 24). Twenty-nine states and the District of Columbia each had more cases in 2015 than 2014, raising questions — but no definitive answers — about a possible resurgence of one of the world’s deadliest diseases.

The overall increase was relatively small: 157 more cases, bringing the 2015 total to 9,563. Two-thirds of the total were among people born abroad, with Asians accounting for the most cases (3,007) and the highest rate (28.2 cases per 100,000 persons). By comparison, there were only .5 cases per 100,000 whites last year.

“After two decades of declining incidence, progress toward TB elimination in the United States appears to have stalled,” the CDC report said. The causes are unclear, it said, and the data need further evaluation if the reasons behind the trend are to be identified.

One contributing factor is likely to be reduced or stagnant funding for prevention efforts nationwide. The disease can be difficult to manage and treat, even more so if substance abuse, incarceration or homelessness are involved. Advocates say that people with TB often have other diseases, such as diabetes, that also complicate treatment.

The authors noted that reports of TB cases among native-born children is further corroboration of the disease’s continued spread in the United States; diagnosis in a young child represents “a sentinel event” signaling recent infection.

Tuberculosis is a potentially serious airborne bacterial disease that primarily attacks the lungs. Despite recent advances, it remains one of the world’s deadliest diseases. The active form is contagious, while people latently infected don’t show symptoms and are not contagious. About 11 million Americas are believed to be in that latter category, according to the CDC’s last estimate in 2000.

The disease is treatable with antibiotics, but the course can be long and complicated. Certain forms of the bacterium that causes TB are becoming impervious to the drugs designed to kill them, leading to the development of multidrug-resistant strains of infection.

More than half of cases reported in 2015 were clustered in four states – California, Florida, New York and Texas – which have one-third of the U.S. population.

“There have been devastating cuts in some states, so they have only been able to react to cases,” said Donna Wegener, executive director of the National TB Controllers Association, which represents all public tuberculosis-control programs at the state and local levels. “We’ve reached the limits of what we can do on prevention.”

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SOURCE: NOLA.com, The Washington Post