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Tuberculosis in the United States
National Surveillance System
Highlights from 2006
Division of Tuberculosis Elimination
Centers for Disease Control and Prevention
Reported TB Cases*
United States, 1982–2006
No. of Cases
28,000
26,000
24,000
22,000
20,000
18,000
16,000
14,000
12,000
10,000
1982
1986
1990
1994
Year
*Updated as of April 6, 2007.
1998
2002
2006
TB Morbidity
United States, 2001–2006
Year
Cases
Rate*
2001
2002
2003
2004
2005
2006
15,945
15,056
14,838
14,502
14,080
13,779
5.6
5.2
5.1
4.9
4.7
*Cases per 100,000, updated as of April 6, 2007.
4.6
TB Case Rates,* United States, 2006
D.C.
< 3.5 (year 2000 target)
3.6–4.6
> 4.6 (national average)
*Cases per 100,000.
TB Case Rates* by Age Group
United States, 1993–2006
Cases per 100,000
20
15
10
5
19
93
19
94
19
95
19
96
19
97
19
98
19
99
20
00
20
01
20
02
20
03
20
04
20
05
20
06
0
<15
15–24
*Updated as of April 6, 2007.
25–44
45–64
>65
Reported TB Cases by Age
Group, United States, 2006
>65 yrs
(19%)
45–64 yrs
(29%)
<15
yrs
(6%)
15–24 yrs
(11%)
25–44 yrs
(34%)
TB Case Rates by Age Group
and Sex, United States, 2006
Cases per 100,000
12
10
8
6
4
2
0
<15 yrs
15–24 yrs
25–44 yrs
Male
45–64 yrs
Female
>65 yrs
TB Case Rates by Race/Ethnicity*
United States, 1993–2006**
Cases per 100,000
50
40
30
20
10
0
1994
1996
1998
2000
2002
2004
Asian/Pacific Islander
American Indian/Alaska Native
Black or African-American
Hispanic
White
*All races are non-Hispanic. In 2003, Asian/Pacific Islander category includes persons who
reported race as Asian only and/or Native Hawaiian or Other Pacific Islander only.
**Updated as of April 6, 2007.
2006
Reported TB Cases by Race/Ethnicity*
United States, 2006
American Indian or
Alaska Native (1%)
White
(17%)
Native Hawaiian or
Other Pacific Islander
(<1%)
Hispanic or Latino
(30%)
Asian
(24%)
Black or
African-American
(27%)
*All races are non-Hispanic. Persons reporting two or more races
accounted for less than 1% of all cases.
TB Case Rates by Age Group and
Race/Ethnicity,* United States, 2006
Cases per 100,000
100
80
60
40
20
0
<5
5–14
15–24
25–44
45–64
>65
Age Group (yrs)
American Indian/Alaska Native
Asian
Hispanic or Latino
Black or African-American
White
Native Hawaiian/Other Pacific Islander
*All races are non-Hispanic. Persons reporting two or more races accounted for
less than 1% of all cases.
Number of TB Cases in
U.S.-born vs. Foreign-born Persons
United States, 1993–2006*
No. of Cases
20000
15000
10000
5000
0
1994
1996
1998 2000
U.S.-born
*Updated as of April 6, 2007.
2002
Foreign-born
2004
2006
Trends in TB Cases in Foreign-born
Persons, United States, 1986–2006*
No. of Cases
Percentage
10,000
60
50
40
8,000
6,000
30
20
10
0
4,000
2,000
0
86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06
No. of Cases
*Updated as of April 6, 2007.
Percentage of Total Cases
Reported TB Cases by Origin and
Race/Ethnicity,* United States, 2006
U.S.-born
Foreign-born**
American Indian
or Alaska Native
(3%)
Asian (2%)
White (33%)
Native Hawaiian/Other
Pacific Islander (<1%)
Hispanic or
Latino (17%)
White (5%)
Hispanic or
Latino (39%)
Asian (40%)
Black or African
American (44%)
Black or African
American (14%)
*All races are non-Hispanic. Persons reporting two or more races accounted
for less than 1% of all cases.
**American Indian or Alaska Native and Native Hawaiian or Other Pacific
Islander accounted for less than 1% of foreign-born cases and are not
shown.
Percentage of TB Cases Among
Foreign-born Persons, United States*
1996
2006
DC
DC
>50%
25%–49%
<25%
*Updated as of April 6, 2007.
TB Case Rates in
U.S.-born vs. Foreign-born Persons
United States, 1993–2006*
Cases per 100,000
40
30
20
10
0
1994
1996
1998
U.S. Overall
*Updated as of April 6,2007.
2000
U.S.-born
2002
2004
Foreign-born
2006
TB Case Rates in
U.S.-born vs. Foreign-born Persons
United States,* 1993–2006**
Cases per 100,000
100
10
1
1994
1996
1998
U.S. Overall
2000
U.S.-born
2002
2004
Foreign-born
*Includes the same data as slide 15, but rates presented on a logarithmic scale.
**Updated as of April 6, 2007.
2006
Countries of Birth of Foreign-born
Persons Reported with TB
United States, 2006
Mexico
(25%)
Other
Countries
(38%)
Philippines
(11%)
Guatemala
(3%)
Haiti
(3%) China
(5%)
India
(7%)
Viet Nam
(8%)
Percent of Foreign-born with
TB by Time of Residence in
U.S. Prior to Diagnosis,* 2006
100%
80%
60%
40%
20%
0%
All
Mexico
<1 yr
Philippines
1–4 yrs
>5 yrs
*Data exclude foreign-born TB patients for when length of
residence in the U.S. prior to diagnosis was unknown.
Viet Nam
Primary Anti-TB Drug Resistance
United States, 1993–2006*
% Resistant
10
5
0
1994
1996
1998
Isoniazid
2000
2002
2004
MDR TB
*Updated as of April 6, 2007.
Note: Based on initial isolates from persons with no prior history of TB.
MDR TB defined as resistance to at least isoniazid and rifampin.
2006
Primary MDR TB
United States, 1993–2006*
No. of Cases
Percentage
500
400
300
200
100
0
3
2
1
0
93 94 95 96 97 98 99 00 01 02 03 04 05 06
No. of Cases
Percentage
*Updated as of April 6, 2007.
Note: Based on initial isolates from persons with no prior history of TB.
MDR TB defined as resistance to at least isoniazid and rifampin.
Primary Isoniazid Resistance in
U.S.-born vs. Foreign-born Persons
United States, 1993–2006*
% Resistant
14
12
10
8
6
4
2
0
1994
1996
1998
U.S.-born
2000
2002
2004
Foreign-born
*Updated as of April 6, 2007.
Note: Based on initial isolates from persons with no prior history of TB.
2006
Primary MDR TB in
U.S.-born vs. Foreign-born Persons,
United States, 1993–2006*
% Resistant
3
2
1
0
1994
1996
1998
U.S.-born
2000
2002
Foreign-born
*Updated as of April 6, 2007.
Note: Based on initial isolates from persons with no prior history of TB.
MDR TB defined as resistance to at least isoniazid and rifampin.
2004
2006
XDR TB Counted Cases
†
defined on Initial DST by Year,
1993–2006*
Case Count
12
10
8
6
4
2
19
93
19
94
19
95
19
96
19
97
19
98
19
99
20
00
20
01
20
02
20
03
20
04
20
05
20
06
0
Year of Diagnosis
*Reported incident cases as of 7/18/07
†
Drug Susceptibility Test
Reporting of HIV Test Results
in Persons with TB by Age Group
United States, 1993–2005*
% with Test Results
80
60
40
20
19
93
19
94
19
95
19
96
19
97
19
98
19
99
20
00
20
01
20
02
20
03
20
04
20
05
0
All Ages
Aged 25–44
*Updated as of April 6, 2007.
Note: Includes TB patients with positive, negative, or indeterminate HIV test
results. Persons from California reported with AIDS only through 2004.
(HIV test results are not reported from California)
Estimated HIV Coinfection in Persons
Reported with TB, United States,
1993–2005*
% Coinfection
30
20
10
0
1993
1995
1997
1999
All Ages
2001
Aged 25–44
*Updated as of April 6, 2007.
Note: Minimum estimates based on reported HIV-positive status
among all TB cases in the age group.
2003
2005
Mode of Treatment Administration
in Persons Reported with TB
United States, 1993–2004*
100%
80%
60%
40%
20%
0%
1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004
DOT only
DOT + SA
SA only
*Updated as of April 6, 2007.
Directly observed therapy (DOT); Self-administered therapy (SA)
Completion of TB Therapy
United States, 1993–2004*
**
80
60
40
20
Completed
04
20
03
20
02
20
01
20
00
20
99
19
98
19
97
19
96
19
95
19
94
19
93
0
19
Percentage
100
Completed in 1 yr or less
*Updated as of April 6, 2007.
**Healthy People 2010 target: 90% completed in 1 yr or less.
Note: Persons with initial isolate resistant to rifampin and children under 15 years
old with meningeal, bone or joint, or miliary disease excluded.