There Are Now Fewer Tuberculosis Cases In The U.S. Than The CDC Has Ever Measured

However, U.S. elimination of this curable disease will not be possible in this century without an uptick in prevention efforts.
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The number of U.S. tuberculosis cases in 2016 was the lowest since the Centers for Disease Control and Prevention began reporting it in 1953, the agency announced Thursday.

However, the CDC cautioned that the goal to eliminate TB from the U.S. will likely not be met in this century without a dramatic strengthening of current control programs and the tracking and treatment of latent TB infections.

We can’t yet say whether this slight decline will continue,” Dr. Phil LoBue, director of CDC’s Division for TB Elimination, said in an email to The Huffington Post. “However, in order to accelerate progress toward TB elimination, we’re going to have to take a new approach that focuses on both strengthening these existing TB control systems and broadening responsibility for latent TB infection testing and treatment efforts.”

Donna Wegener, the executive director of the National TB Controllers Association, was heartened by the reported decrease, but she worries the extent of the decrease indicates progress has stalled.

David Bryden, a TB advocate for the nonprofit Results, also stressed the U.S. should be making much faster gains in the fight against TB.

“It’s a slow rate of decline, and this is a very serious epidemic,” Bryden said. “This is no reason to be complacent or to think that now we are again on the downward trajectory as next year it could go up again.”

The CDC’s annual report highlights that about 13 million Americans have what’s called latent TB, a form of tuberculosis that lies dormant in the body.

About 5 to 10 percent of people infected with TB will eventually develop the active, infectious form of the disease. That means as many as 1.3 million Americans could become infectious over the span of their lifetimes if they don’t receive preventive treatment.

Alissa Scheller/The Huffington Post

According to the CDC, a total of of 9,287 TB cases were reported in 2016, which is an incidence rate of 2.9 per 100,000 people. About 85 percent of TB cases in the U.S. are due to latent reactivation, Lobue estimated.

The 2016 numbers reflect a drop of 259 cases from the 9,546 reported for 2015, the first year that the number of cases had risen in the U.S. since 1992.

Eighteen states reported an uptick in cases, with just over half of the overall cases coming from four states: California, New York, Florida and Texas.

Alissa Scheller/The Huffington Post

While funding for the CDC was not specified in the president’s “skinny budget” proposed March 16, health experts are concerned the CDC’s budget could be cut. The president’s proposed budget included an 18 percent cut to the budget of the National Institutes of Health and a proposed 28 percent cut to the State Department and U.S. Agency for International Development combined. NIH and USAID work alongside the CDC on TB control, research and prevention in the U.S. and around the globe.

Any cut in funding could be devastating, and costly, in the U.S. fight against tuberculosis, according to LoBue, who pointed out that health departments and CDC TB control efforts have prevented as many as 300,000 people from developing TB, saving an estimated $6 billion along the way.

“Cuts to funding could impact local and state health department TB prevention services. This could mean weakening the capacity of these health departments to investigate contacts of persons with TB disease or limiting their ability to analyze DNA of TB bacteria to test for drug resistance,” LoBue said. “This could lead to increases in TB cases and costs for the health care system.”

Wegener stressed that any cuts could devastatingly set back U.S. prevention efforts and that an increase in funding is needed to properly fight TB.

“We need a significant infusion of federal, state and local dollars. We need a commitment to address a national prevention effort for TB,” she said. “We are poised and ready to take this next step ― we just need the political will and funding commitments.”

Alissa Scheller created the graphics for this report.

And for more on battling TB in the U.S., read here.

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