From the Guidelines
Tuberculosis cases in the United States are relatively uncommon, with approximately 9,412 cases reported in 2014, translating to a rate of 3.0 cases per 100,000 persons 1. The epidemiology of TB in the United States is characterized by a higher incidence among foreign-born individuals, with a rate 13.4 times higher than in US-born individuals 1. Some key factors to consider include:
- The total number of reported TB cases in the US has been declining over the years, but the rate of decline has slowed down recently 1.
- An estimated 11 million persons are infected with Mtb, posing a significant risk for new cases to develop from this group 1.
- The transmission of Mtb is influenced by factors such as the infectiousness of the source patient, host susceptibility, duration of exposure, and environment 1.
- Among contacts of patients with TB disease, about 1% have TB disease themselves, and 23% have a positive tuberculin skin test without evidence of tuberculosis disease, indicating latent TB infection 1. Given the low incidence of TB in the US, it is essential to maintain robust public health infrastructure for early detection and treatment of active cases, as well as continued attention to high-risk groups and latent TB infection treatment to eliminate TB in the US 1.
From the Research
TB Cases in the United States
- The incidence of reported tuberculosis (TB) in the United States has been decreasing over the years, with a notable decline in 2020 due to the COVID-19 pandemic 2, 3.
- In 2022, the TB incidence increased slightly to 2.5 cases per 100,000 persons, although it remained lower than during pre-pandemic years 2.
- The number of TB cases reported in the United States has been steadily decreasing since 1993, with a total of 8,300 TB cases provisionally reported in 2022 2.
- The TB incidence varies by birth origin, with non-U.S.-born persons having a higher rate of TB than U.S.-born persons 2, 4.
- Disparities in TB incidence also exist by race and ethnicity, with certain groups such as non-Hispanic American Indian or Alaska Native and non-Hispanic Native Hawaiian or other Pacific Islander persons having higher rates of TB 2.
Trends in TB Incidence
- The decline in TB incidence in 2020 was attributed to factors such as delayed or missed TB diagnoses, changes in migration and travel, and mortality among persons susceptible to TB reactivation 2, 3.
- The increase in TB incidence in 2021 was partially explained by delayed diagnosis of cases in persons with symptom onset during 2020 5.
- The continued reduction in TB incidence from pre-pandemic levels raises concern for ongoing underdiagnosis 5.
Efforts to Control TB
- Efforts to control and prevent TB, including early diagnosis and complete treatment of TB and latent TB infection, are crucial to achieving elimination in the United States 5, 6.
- Partnerships with healthcare providers, including private providers, are essential for the success of TB elimination strategies 4.
- Continued vigilance to ensure ongoing control of TB transmission remains key to achieving the goal of eliminating TB from the United States 6.