20-year decline in TB incidence in US has stalled: 5 things to know

After two decades of steady decline, measurable progress toward tuberculosis elimination has flatlined, according to the Morbidity and Mortality Weekly Report published by the CDC.

Here are five things to know about the stall in TB decline:

1. For two decades, incidents of TB trended downward, but from 2013 to 2015 they remained at three new cases per 100,000 people.

2. The rate of TB incidence among foreign-born persons in the United States is 13 times greater than the incidence among people born in the U.S. These cases often occur years after these individuals arrive in the U.S. Progress toward TB elimination in the U.S. will require the intensification of both global and domestic reduction efforts.

3. California, Florida, New York and Texas collectively accounted for 4,839 (50.6 percent) of all reported TB cases, though Hawaii (8.9) and Alaska (9.1) had the highest instances of infection per 100,000 people.

4. Among TB cases attributable to U.S.-born individuals, Native Hawaiians/Pacific Islanders had the highest incidence with 12.7 cases per 100,000. Non-Hispanic blacks carried an all-time-low rate of infection for their demographic with 3.3 cases per 100,000 persons. TB incidence among U.S.-born non-Hispanic whites remained the lowest with 0.5 cases per 100,000 persons. U.S.-born Hispanics had the second lowest rate of infection with 1.8 per 100,000.

5. The report calls for TB transmission reduction in institutional settings, an increased focus on TB detection and treatment in U.S. populations most affected by the disease, limiting transmissions amongst the homeless and continued research into superior methods of TB detection and treatment.

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