TB on the rise in foreign-born U.S. residents: CDC

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TB on the rise in foreign-born U.S. residents: CDC

Last Updated: 2004-03-19 10:49:07 -0400 (Reuters Health)

By Simao

ATLANTA (Reuters) - A global tuberculosis epidemic helped fuel a jump in

cases last year in California, Texas and other U.S. states with large

immigrant populations, according to a federal study released on

Thursday.

More than 53 percent of the 14,871 new U.S. cases of active TB last year

occurred among people born abroad to non-U.S.-born parents, according to

a report by the Centers for Disease Control and Prevention. About 11.5

percent of the overall U.S. population is foreign born.

The proportion of cases for this group was the highest since 1986, when

the United States began collecting birthplace data for TB patients. TB

cases rose in California, Texas, New York and 16 other states in 2003,

but fell in the nation as a whole.

Dr. Eileen Schneider, an epidemiologist with the CDC's tuberculosis

elimination division, said the 1.9 percent drop in the U.S. infection

rate last year was the smallest decline since 1992, when the disease

peaked.

" We're not sure if this is just a plateau or a resurgence, " said

Schneider, who added that a decline in TB among U.S.-born residents

contributed to the rising percentage of foreign-born patients captured

in the 2003 data.

Five years ago, foreigners made up 41.7 percent of the nation's TB

caseload.

Once a leading killer, tuberculosis has been declining in the United

States since the height of the AIDS epidemic in the early 1990s. AIDS

attacks the immune system and renders the body unable to fight

opportunistic infections such as TB.

Efforts to control the scourge, spread by coughing and close personal

contact and usually cured with antibiotics, have been stymied in part by

the spread of TB overseas. An estimated eight million new cases are

reported worldwide every year, leading to 2 million deaths.

In 2003 Mexicans accounted for about one quarter of foreign-born U.S.

patients with TB. Filipinos, Vietnamese, Indians and Chinese also had

high rates of the infection.

The CDC said it was working to improve tuberculosis screening for U.S.

visa applicants overseas as well as for high-risk groups within the

United States and hoped to establish a closer relationship with

authorities fighting the disease along the U.S.-Mexican border.

Three most populous states - California and Texas, which both share a

border with Mexico, and New York - accounted for 42.4 percent of TB

cases last year.

In addition to the worrying TB trend among the foreign-born, the CDC

also revealed high infection rates in blacks and other minorities.

U.S.-born blacks were about 7.5 times more likely than whites to have TB

last year.

SOURCE: Morbidity and Mortality Weekly Report, March 19, 2004.

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