March 24, 2001, will mark the 19th annual World TB Day, which recognizes
the collaborative efforts of all countries involved in eliminating tuberculosis (TB). TB
is the second leading cause of death among infectious diseases worldwide.
An estimated 2 billion persons---one third of the world's population---are infected
with the bacteria that cause TB, and approximately 2 million persons die each
year from TB.
After years of decline in the United States, the number of reported TB
cases increased 20% during 1985--1992. This resurgence was associated
with deterioration of the infrastructure for TB services; the human
immunodeficiency virus epidemic, which substantially increased the risk for active TB among
persons with latent TB infection; immigration of persons from countries where TB
was endemic; TB transmission in congregate settings (e.g., hospitals and prisons);
and development of multidrug-resistant TB. However, a renewed emphasis on
TB control and prevention in the mid-to-late 1990s resulted in substantial declines
in the disease. In 2000, the provisional number of TB cases decreased for the
eighth straight year to an all-time low of 16,372 cases, a 7% decrease over the
17,531 cases reported in 1999.
In 2000, the Institute of Medicine (IOM) released a CDC-commissioned
report on the feasibility of eliminating TB in the United States. The report supports
a statement by the Advisory Council for the Elimination of Tuberculosis that
commits to the goal of eliminating TB in the United States. The IOM report states that
more aggressive and decisive action will be required for TB elimination. The report
also recommends that the United States further engage in global TB prevention
and control efforts. Some of CDC's efforts in this area, specifically projects in
the Russia Federation, are highlighted in this issue of
MMWR. Additional information on World TB Day and CDC's global TB activities are available on the
World-Wide Web, http://www.cdc.gov.
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