TB Cases by Age and Race/Ethnicity, 2008

Intervention efforts targeting those at high risk for TB are essential to eliminate this disease in the U.S.

Chart: Reported TB Cases by Age Group, United States, 2008. Pie chart showing the breakout of reported TB cases by age group. <15 years: 6%; 15-24 years: 11%; 25-44 years: 34%; 45-64 years: 30%; >64 years: 19%.

TB is an airborne infectious disease caused by bacteria called Mycobacterium tuberculosis. TB is spread through the air from one person to another. The bacteria are put into the air when a person with active TB disease of the lungs or throat coughs, sneezes, speaks, or sings. Every person with TB disease has the potential to infect others, if not promptly diagnosed and treated. Despite efforts targeted at interrupting transmission, all 50 states and the District of Columbia continue to report TB cases. In 2008, a total of 12,904 TB cases were reported to CDC. This represents a decline of 2.9% from 2007 and a 54% decline from 1980.

Although the number of tuberculosis (TB) cases has declined substantially in all age groups over the past decade, TB among the elderly remains a concern. Risk factors, including residence in congregate settings (e.g., nursing homes) and co-morbidities such as diabetes, place elderly persons at higher risk for TB disease. Adults and the elderly had the highest burden of TB disease in the U.S. in 2008. The number of TB cases was highest among adults ages 25 to 44 (33% of all cases), followed by adults ages 45 to 64 (30%), the elderly ages 65 and older (19%), young adults ages 15 to 24 (11%), and children ages 14 and younger (6%). It is important to note that the elderly had the highest case rate (6.4 per 100,000) compared to all other age groups, despite having only the third largest case count.

Risk increased with age across racial and ethnic groups, with rates generally higher in minority racial and ethnic groups than in non-Hispanic whites. Rates were the highest in Asians and Native Hawaiians and Other Pacific Islanders, particularly in the elderly. The impact of foreign birth is a consideration in interpreting rate variations by race/ethnicity. For example, foreign-born persons accounted for 95% of cases among Asians, in contrast to 18% among non-Hispanic whites.

Improved access to appropriate care for populations at higher risk for TB is essential to reach the goal of TB elimination in the U.S.

Chart: TB Case Rates (Cases per 100,000) by Age Group and Race/Ethnicity, United States, 2008.

References:

CDC. Reported Tuberculosis in the United States, 2008. Atlanta, GA: U.S. Department of Health and Human Services, CDC, September 2009.
CDC. Screening for Tuberculosis and Tuberculosis Infection in High-Risk Populations Recommendations of the Advisory Council for the Elimination of Tuberculosis. MMWR 1995; 44(RR-11):18-34