Tuberculosis

Background

Tuberculosis (TB) causes more deaths than any other infectious disease in the world with more than 10 million new cases and nearly two million deaths in 2016. TB is caused by a bacterium known as Mycobacterium tuberculosis. The bacteria usually attack the lungs, but TB bacteria can attack any part of the body, including the kidney, spine, and brain. Since not everyone infected with TB bacteria becomes sick, two TB-related conditions exist: latent TB infection (LTBI) and TB disease. If they are not treated properly, TB disease can be fatal.

Tuberculosis Data Overview

Check out the points below for the main takeaways from this page. 

• The TB incidence rate has been declining in the United States (U.S.) since 1953 when aggressive public health measures were put into place to reduce the transmission of TB. In 2018, 2.8 in 100,000 people were newly diagnosed with TB. 

• In 2018, a total of 70.2% of reported TB cases in the U.S. occurred among non-U.S.-born people. In Hillsborough County, 81% of reported TB cases occurred among non-U.S.-born people. 

• Differences exist in TB incidence rates between different racial, ethnic, and geographical communities. The incidence of TB is higher in Asian, Hispanic/Latino, and Black/African American groups than in White/Caucasian groups. 

TB by County and Origin

TB disease in the U.S. is most common among people born in countries with high rates of TB. 

In 2018, 70.2% of reported TB cases in the U.S. occurred among non-U.S.-born people (CDC). We encourage people who have spent time in countries where TB is more common to get tested to prevent the spread.

TB by Age and Origin

TB rates are higher among people 25 to 44 years of age. 

In 2018, 30.2% of NH TB cases were in adults 25 to 44 years of age. Although less common, TB detected in children under 15 years of age is a significant public health problem as it is a marker for recent transmission. In young people, the greatest numbers of TB cases are seen in children younger than 5 years of age and older than 10 years of age.

Latent TB vs. TB Disease

When most people breathe in TB bacteria and become infected, their body is able to fight the bacteria to stop them from growing. Most people infected with TB bacteria will develop latent TB infection where the bacteria will remain inactive for a lifetime without causing illness. Approximately 13 million people in the U.S. are living with latent TB infection. In other people, especially people who have a weak immune system, the bacteria become active, multiply, and cause TB disease. 

Latent TB Infection

TB bacteria can live in an individual without them feeling sick. This is known as latent TB infection, or latent TB infection. People with latent TB infection do not have symptoms, do not feel sick, can not spread TB to others, and usually have a positive test. Most people with latent TB infection never develop TB disease, but it is possible if they do not receive treatment. 

TB Disease

TB bacteria become active if the immune system can not stop them from growing. When TB bacteria are actively multiplying in someone's body, this is known as TB disease. People with TB disease feel sick, show symptoms, and are able to spread the bacteria to people they spend time with.

Drug Resistant TB

In most cases, TB is treatable and curable. If someone with TB does not receive proper treatment, it can result in death. Drug-resistant TB (DR TB) occurs when TB bacteria become resistant to the drugs used to treat it, and a drug can no longer kill it. Drug-resistant TB is a result of misuse or mismanagement of TB drugs. Drug-resistant TB is spread through the air when someone breathes drug-resistant TB bacteria from an infected person with drug-resistant TB disease of the lungs or throat when they cough, sneeze, or speak. Although drug-resistant TB is rare in the U.S., its rates have been increasing around the world. 

Drug Resistant TB Data Snapshot

Treatment for drug-resistant TB is extremely costly and disruptive to the person infected. In 2016, the cost to treat someone ranged from $18,000 to $513,000. If a patient experiences productivity losses, such as lost income, costs can be even higher. Despite high costs, the percentage of TB cases that are drug resistant has remained stable in the U.S.

Isoniazid Resistance: Isoniazid resistant TB is the most common occurring type of TB resistance in the U.S. In 2018, isoniazid resistance occurred in 9.4% of TB cases with drug susceptibility results. (CDC)

Multidrug-Resistant TB: Multidrug-resistant TB (MDR TB) is caused by TB bacteria that is resistant to the two most effective TB treatment drugs, isoniazid and rifampin. In 2018, multidrug-resistant TB occurred in 1.5% of TB cases with drug susceptibility results. (CDC)

Health Disparities and TB

Health disparities can cause some people to be more susceptible to TB infection. 

Differences exist in TB incidence rates between different racial, ethnic, and geographical communities. These disparities are most likely related to disproportionate exposure, vulnerability, and access to diagnosis and treatment. Although the incidence of TB has drastically decreased in the U.S., the percentage of TB cases that occur in Hispanics, blacks or African Americans, and Asians is higher than expected based on the percentage of these minorities in the U.S. population. According to the MediBulletin Bureau, between the years of 2007 to 2017, the U.S saw approximately 0.1 new cases per 100,000 non-Hispanic white young adults each year, a number that is compared with four new cases per 100,000 Asian young adults.

Health Equity & Tuberculosis

A person's health can be seriously impacted by their race, ethnicity, gender, income level, education, and other socioeconomic factors. In regards to tuberculosis...

• The percentage of TB cases that occur in Hispanic, Black, and Asian people is higher than expected based on the percentage of these minorities in the U.S. population (CDC).

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