The number of tuberculosis (TB) cases reported in the United States declined by seven percent from 1999 to 2000, continuing an eight-year downward trend since the TB epidemic peaked in 1992, according to data released by the Centers for Disease Control and Prevention (CDC).
A total of 16,377 TB cases were reported from the 50 states and the District of Columbia in 2000, an all-time low, down from 17,531 cases in 1999.
Since the 1992 peak, the rate of TB cases has dropped 45 percent, from 10.5 cases per 100,000 people in 1992 to 5.8 cases per 100,000 in 2000.
"While the 2000 national TB figures highlight the effectiveness of U.S. TB control efforts, the disease still remains a significant health threat in many parts of this country," said Dr. Jeffrey Koplan, director of CDC. "To eliminate TB as a public health problem in the United States, efforts will need to be accelerated in those states and communities most affected by the disease."
Top 10 States With Highest Rates
CDC also released data on the 10 states with the highest TB rates -- the number of TB cases per 100,000 people -- pointing to several areas where prevention and control efforts must be accelerated.
The 10 states that led the nation with the highest rates in 2000 were Alaska, Hawaii, California, New York, Georgia, Arkansas, Louisiana, Florida, Texas and South Carolina.
Seven of the top 10 states had a decrease in TB rates between 1999 and 2000, but three states -- Alaska, Arkansas and Georgia -- reported increases in rates.
Alaska had the most dramatic rise in rates from 9.9 in 1999 to 17.2 in 2000. TB rates in Arkansas climbed from 7.1 to 7.4 and the rates in Georgia increased slightly from 8.5 to 8.6.
Historically, U.S. TB rates declined steadily from 1953 until 1985, when cases began to increase following a sharp cut in TB control resources in the 1970s and the spread of HIV/AIDS in the 1980s.
TB cases increased by 20 percent from 1985 to 1992, a climb that was reversed with the strengthening of TB control activities, including screening and treatment in 1992, according to CDC.
In contrast to the downward trends in the United States since 1992, TB continues unabated globally with 8 million new TB cases each year and 2 million deaths attributed to TB.
"The growing global TB epidemic could impact the declines made in the United States, if TB defense systems are not maintained," said Dr. Helene Gayle, director of CDC''s National Center for HIV, STD and TB Prevention. "Innovative approaches and support, as well as a commitment to global TB control, will be required to eliminate this disease from the United States."
by Virginia Sutcliffe