TB Notes 52017
Notes from the Director
Earlier this year, the Division of Tuberculosis Elimination (DTBE) released provisional 2016 surveillance data on reported tuberculosis (TB) cases in the United States. The full report, entitled Reported Tuberculosis in the United States, 2016, is now available online.
DTBE has developed a slide set, fact sheet, infographicpdf icon, and web graphics with highlights from the surveillance report to support TB education and outreach to clinicians, health care agencies, and community organizations. TB control programs can use a new CDC customizable infographic template to highlight state and local surveillance data.
The CDC National Tuberculosis Surveillance System has collected information on each newly reported case of TB disease since 1953. Tracking our progress towards TB elimination would not be possible without the cooperation of the 60 reporting areas across the United States. We hope this report will be a useful tool in informing and improving TB prevention and control activities. To learn more, visit the CDC TB website, or follow us on Facebook and Twitter.
Thank you for your work and commitment to eliminate TB.
Philip LoBue, MD, FACP, FCCP
Division of Tuberculosis Elimination
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
TB remains under control in the United States, but current strategies will not be sufficient to reach the goal of TB elimination in this century.
A total of 9,272 TB cases were reported in the United States in 2016 according to data from the CDC National TB Surveillance System. This represents a decrease of 275 from the 9,547 cases reported in 2015. TB cases were reported in all fifty states and the District of Columbia. The 2016 case count represents the lowest number of TB cases on record in the United States. The national incidence rate was 2.9 cases per 100,000 persons (3.6% decrease from 2015).
TB in Specific Populations
TB disease remains more common among people who were born in countries with high rates of TB. The majority of these cases are among persons who have been in the United States 5 years or longer. Minority populations continue to disproportionately bear the burden of TB disease
Prompt and effective treatment of TB disease is critical to prevent ongoing transmission of TB. A typical TB case in the United States costs $18,000 to treat and requires at least 180 days of medication, plus x-rays, lab tests, and follow-up and testing of contacts. In 2014, the most recent year for which completion data are available, of TB patients who could be appropriately treated within 1 year of diagnosis, 90.1% completed treatment.
Drug-resistant TB is complex and costly to treat. A single case of multidrug-resistant TB costs $160,000 to treat. Treatment costs for one case of extensively drug-resistant TB are $513,000.
In 2016, there were 96 cases of multidrug-resistant TB and one case of extensively drug-resistant TB reported in the United States. The percentage of TB cases that are drug resistant has remained stable for the last 20 years.
In a new section of the annual TB surveillance report, CDC is including the numbers of TB cases attributed to recent transmission. CDC estimates that about 14% of U.S. TB cases with genotype data are attributed to recent transmission.
Distinguishing the numbers of cases attributed to recent transmission from those likely due to reactivation of longstanding, untreated latent TB infection is one of many tools state and local TB programs can use to design and prioritize effective public health interventions. These estimates can be used by state and local TB programs to track progress in the control of recent transmission.
The cycle of TB transmission can be ended by early diagnosis, infection control, and treatment of patients with TB disease; and by identifying and treating contacts with latent TB infection to prevent the progression to TB disease.
The 2016 TB Surveillance Report has additional information on TB trends, risk factors, and more. The data are also available through CDC’s AtlasPlus online tool.
CDC has developed communication resources with highlights from the 2016 Surveillance Report for state and local TB programs. We encourage state and local TB programs and partners to use these materials to talk about TB in your communities, and to continue the important work towards TB elimination.