CDC Logo Tuberculosis Information CD-ROM   Image of people
jump over main navigation bar to content area
TB Guidelines
Surveillance Reports
Slide Sets
TB-Related MMWRs and Reports
Education/Training Materials
Ordering Information


U.S. Department of Health and Human Services


This is an archived document. The links are no longer being updated.

TB Notes 1, 2001

Dear Colleague:

On March 1, the Division of TB Elimination (DTBE) released the provisional TB data for the United States for 2000. Once again U.S. TB cases have reached a record low: a total of 16,372 cases were reported, representing a 7% decrease from the number of cases reported in 1999. My thanks and congratulations to all of you in TB control who are responsible for these great strides!

As we have done in the past, CDC and many of its partners observed World TB Day in March. World TB Day is held on March 24 each year to commemorate the date in 1882 when Dr. Robert Koch announced to a group of scientists in Berlin, Germany, his discovery of the causative agent of TB and his evidence from exhaustive experiments that proved it. Many state and local health departments took advantage of the event to organize and stage an impressive number of activities about TB, such as press conferences, press releases, health fairs, information booths, educational displays and presentations, op-ed pieces, World TB Day proclamations, and other programs too numerous to mention. Many of these events were undertaken in collaboration with representatives of local lung associations and the nongovernmental organization "Results." CDC observed the occasion on Friday, March 23, through various media: CDC featured World TB Day as a "Spotlight" item on its Internet home page the week of March 19; World TB Day information was also posted on the DTBE Web site. DTBE staff had the following two articles published in the March 23 MMWR: (1) Evaluation of a directly observed therapy short-course strategy for treating tuberculosis - Orel Oblast, Russian Federation, 1999-2000. MMWR 2001;50(11):201-206, and (2) Tuberculosis treatment interruptions - Ivanovo Oblast, Russian Federation, 1999. MMWR 2001; 50(11):201-206. The National Center for HIV, STD, and TB Prevention (NCHSTP) Office of Communications developed a media strategy and press kit around the MMWR articles. DTBE also sponsored an event at the CDC Global Health Odyssey on March 23. (The Global Health Odyssey, CDC's museum, is a small exhibit area with an attached theater. For more information on the Global Health Odyssey go to This event involved guest speakers from the community, the American Lung Association, the World Health Organization, DTBE, and the CDC Director's office. An exhibit displaying vintage TB posters from around the world was featured. The Communications and Education Branch of DTBE developed a variety of World TB Day materials that were sent to TB Controllers the week of March 5th. These materials included a fact sheet and trends document, a media relations guide, and a World TB Day poster. The World Health Organization and the American Lung Association issued press releases. I hope you took advantage of the occasion to promote awareness about TB in your area, and to educate as many people as you could that TB is still a problem and that it can be eliminated if we all work together. Judging from the reports we received from state and local health departments about their World TB Day activities, it appears that many of you did.

In January DTBE began pilot-testing a new system for formally receiving reports initiated by state and local TB Controllers about suspected TB outbreaks. We also had an opportunity for discussion of this system during a recent conference call with members of the National TB Controllers Association (NTCA). This process will allow DTBE to consistently account for the information shared with us. One component of the new reporting system will allow DTBE to track its response and follow-up to outbreaks. It is expected that this systematic documentation of reported outbreaks and CDC's responses to them will aid in documenting our requests for increased resources for TB prevention and control. It should not change the way outbreaks are reported to CDC and should not impose any additional burden on TB control programs. We encourage TB control programs to continue sharing information with DTBE so that resource-intensive events such as outbreaks can be documented and followed up.

The Advisory Council for the Elimination of Tuberculosis (ACET) met in Atlanta on February 13 and 14; following are some highlights. In the Directors' reports, attendees learned that the overall CDC budget was increased by 26%, with all NCHSTP divisions receiving small increases. The legal and statutory implications of the IOM report were reviewed at a special public health law symposium held at CDC. I convened the meeting in collaboration with Tony Moulton, project officer for CDC's Public Health Law Project. The symposium attracted participants from other areas in CDC. Dr. John Ridderhoff of CDC's Public Health Practice Program Office (PHPPO) gave an update on the draft standards for TB drug susceptibility testing developed by the National Committee of Clinical Laboratory Standards (NCCLS); ACET will review the recommendations and issue its findings before the end of the public comment period, January 2, 2002. We heard from the committee that developed and released the IOM report Tuberculosis in the Workplace. One conclusion of the committee is that current fit testing methods are not successful; ACET strongly recommended additional research in this area. Dr. Renee Ridzon of DTBE's Surveillance and Epidemiology Branch discussed the current status of the revision of the MMWR report "Guidelines for preventing the transmission of Mycobacterium tuberculosis in health-care facilities, 1994." Some of the proposed changes: the importance of administrative controls will be stressed; guidance to laboratories will be broadened; and the sections on personal respirators and on engineering controls will be extensively augmented. CDC's response to the IOM report Ending Neglect: The Elimination of Tuberculosis in the United States proposes a number of initiatives; the regionalization of certain TB services has been proposed as the first activity. Dr. John Jereb of DTBE's Field Services Branch reported on two cases of hepatitis in persons taking rifampin and pyrazinamide for the treatment of latent TB infection (LTBI); the findings have been published in the Morbidity and Mortality Weekly Report (MMWR) series. Dr. Rick O'Brien of DTBE's Research and Evaluation Branch discussed the TB Trials Consortium's Study 26, which will test a short course of the new TB drug rifapentine to improve adherence to LTBI treatment; currently, however, the study has not enrolled enough participants to proceed. For the last presentation, Dr. Tom Shinnick of CDC's Division of AIDS, STD, and TB Laboratory Research discussed possible roles for laboratory activities, such as DNA fingerprinting, in low-incidence areas. CDC would encourage these areas to enter into partnerships to explore the feasibility of regionalized lab services, as suggested by the IOM report. The group then reviewed the latest draft of the ACET document on low-incidence areas; since members felt that several issues and terms need to be clarified, we will apparently be working on this document a little longer.

As you have heard by now, the 2001 National TB Controllers Workshop will be held June 19-21, 2001, at the Wyndham Baltimore Inner Harbor, located in downtown Baltimore. The theme for this year's workshop is "Ending Neglect - Accelerating the Decline in TB." The attendees will focus on better understanding and planning for TB-related immigration issues, patient language and cultural barriers, targeted testing of high-risk groups and treatment of latent TB infection, and the role of the United States in the global fight against TB. There will be an update on the TB cooperative agreements. The workshop committee has also invited attendees to submit poster abstracts. I look forward to seeing you there!

Kenneth G. Castro, MD


Released October 2008
Centers for Disease Control and Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Division of Tuberculosis Elimination -

Please send comments/suggestions/requests to:, or to
CDC/Division of Tuberculosis Elimination
Communications, Education, and Behavioral Studies Branch
1600 Clifton Rd., NE - Mailstop E-10, Atlanta, GA 30333