Earlier this year, the Centers for Disease Control and Prevention (CDC), 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. 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.
The DTBE has developed a slide set, fact sheet, infographic, 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.
Key findings: In 2016, the 50 states and the District of Columbia (herein referred to as the “United States”) reported 9,272 TB cases to CDC, representing the lowest number of annual cases on record and a 2.9% decrease from 2015. The national TB incidence rate was 2.9 per 100,000 persons, a 3.6% decrease from 2015. While the reversal of the increase in cases observed in 2015 is a positive sign, the pace of TB’s decline in the United States remains too slow to achieve TB elimination in this century. As reported in earlier years, TB case counts are highest in four states: California, Texas, New York, and Florida. Together, they accounted for just over half of the cases reported by the 50 states and DC. Twelve states and DC reported incidence rates above the national average.
Among Metropolitan Statistical Areas (MSA) with ≥500,000 population in 2016, the New York-Newark-Jersey City MSA reported the greatest number of cases (917), followed by Los Angeles-Long Beach-Anaheim (756 cases), Houston-The Woodlands-Sugar Land (350 cases), and San Francisco-Oakland-Hayward (337 cases). However, McAllen-Edinburg-Mission, Texas (9.9), Urban Honolulu (8.9), San Jose Sunnyvale-Santa Clara (8.1), and San Diego Carlsbad (7.8) reported the highest incidence rates per 100,000 persons.
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 CDC National Tuberculosis Surveillance System has collected information on each newly reported case of TB disease since 1953. Tracking 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.
CDC has also 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.
TB remains a serious problem in the United States even though it is both preventable and curable. Persons with TB are in every state, in rural areas and cities, in schools, workplaces, homes, and many other places where people are in close contact.