In 2009, the rate of tuberculosis (TB) cases dropped to 3.8 per 100,000 population, a decrease of 11.4% from 4.2 cases reported in 2008. This decline is the greatest single year decrease in the rate of TB, and the lowest rate of TB ever seen in the US since TB surveillance began in 1953.
Various ethnic groups of respective national origin manifested the highest TB rates (per 100,000 population) in the US in 2009: Whites = 0.9, Blacks = 7.6, Asian = 23.4,
Hispanic = 7.0, Other (American Indian /Alaskan Native, Native Hawaiian and other Pacific Islander, and multiple race) = 3.0. Persons identified as Hispanic might be of any race. See Table http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5910a2.htm?s_cid=mm5910a2_e#tab
TB Rates for all ethnic groups have been falling as observed in the National TB Surveillance System. See Figure 2: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5910a2.htm?s_cid=mm5910
The lowest TB rate for 2009 was seen in Wyoming, at 0.4 /100,000. The highest was seen in Hawaii, at 9.1. See Figure 1 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5910a2.htm?s_cid=mm5910a2_e#fig1
US born subjects with TB numbered 4,499 cases, 39.8% of the 11,305 cases with known national origin in 2009, down from 5,282 reported in 2008. The rate was 1.7 per 100,000, down 15.8% from 2008. 1,861 cases recorded were Black, 41.4 % of US-born cases.
The TB rate among foreign-born persons in 2009 was 18.6/100,000 population, a 9.0% decrease from 2008, and 45.3% decrease since 1993. Foreign-born individuals accounted for 50.1% of TB cases in 2009, originating from Mexico (1,574), the Philippines (799), India (523) and Vietnam (514).
10.2% of persons with a known HIV test result were co infected with TB and HIV.
TB sensitivity data was available in some cases. For persons with a previous history of TB and found infected again, the risk of multidrug resistant TB (MDR TB) was 4 times higher than for those presenting for the first time with TB; foreign-born cases had higher rates of MDR TB. As of 2009, no new cases of extensively drug-resistant TB have been reported.
Drug therapy for most types of TB is 6 to 9 months. Effective screening, early effective INH prophylaxis in PPD converters found in inner city clinics, where foreign-born patients are frequently encountered contributes to the ongoing drop in US TB rates. Also, effective direct and PEP drug treatment applied to the HIV epidemic has contributed to the lasting fall in TB rates in the US since 1993.