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TB Notes 1, 2007
Director's Letter
Highlights from State and Local Programs
  Maine’s Contact Investigation Course for Public Health Nurses: A Model for Regional Collaboration
  Washington State TB Program Hosts Regional Meeting
  Midwest TB Controllers Meeting
World TB Day “TB Awareness Walk”
TB Program Evaluation Toolkit Shared with Evaluators
Public Health Information Network Conference, September 2006
QuantiFERON-TB Gold Education: Responding to the National Need
TB Education and Training Network Updates
  TBETN Member Highlight
International Research and Programs Branch Update
  Oral Presentation at the 2007 IUATLD North America Region Conference
Surveillance, Epidemiology, and Outbreak Investigations Branch Updates
  Release of 2005 TB Surveillance Report
  Update on Research Priorities of the TBESC
New CDC Publications
Personnel Notes
Calendar of Events
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TB Notes Newsletter

No. 1, 2007

Surveillance, Epidemiology, and Outbreak Investigations Branch Updates

Release of 2005 TB Surveillance Report

This year’s Annual Surveillance Report, Reported Tuberculosis in the United States, 2005, was released October 2006, and is posted on the Internet. Hard copy versions were made available in mid November 2006. A new section of the report that was created this year contains information on U.S.-affiliated Pacific Island jurisdictions.

Statistical highlights of Reported Tuberculosis in the United States, 2005, include the following:

  • Updated case counts for each year from 1993 through 2004
  • Change in calculation of case rates for 2005 using unrounded figures
  • Case counts: 14,097 TB cases were reported to CDC from the 50 states and the District of Columbia, representing a 2.9% decrease from 2004
    • 20 states reported increases in case counts
    • California, New York, Texas, and Florida accounted for 48% of the overall 2005 national case total
    • For the second consecutive year, Hispanics (29%) exceeded non-Hispanic blacks (28%) as the racial/ethnic group with the largest percentage of total cases
    • Blacks or African Americans represented 45% of TB cases in U.S.-born persons and accounted for more than one fifth of the overall national case total
    • Hispanics and Asians each represented 40% of TB cases in foreign-born persons and together accounted for almost 45% of the overall national case total
  • Case rates: The TB case rate declined from 4.9 to 4.8 per 100,000 population, representing a 3.8% decrease from 2004
    • 12 states and DC reported rates above the national average
    • 26 states met the definition for low incidence (<3.5 cases per 100,000 population)
    • The TB case rate was 2.5 per 100,000 for U.S.-born persons and 21.9 for foreign-born persons
    • Asians and Native Hawaiians or Other Pacific Islanders continue to have the highest case rate among all racial and ethnic groups
  • Burden in the foreign-born: The proportion of all cases occurring in foreign-born persons was 55%
    • 22 states had >50% of total cases among foreign-born persons
    • 6 states had >70% of total cases among foreign-born persons
    • The top five countries of origin of foreign-born persons with TB were Mexico, the Philippines, Vietnam, India, and China
  • Drug resistance: The proportion of cases with primary multidrug-resistant TB remained approximately 1.0%

Following are suggested citations for hard copy and online versions:

Hard copy: CDC. Reported Tuberculosis in the United States, 2005. Atlanta, GA: U.S. Department of Health and Human Services, CDC, September 2006.

Online: Centers for Disease Control and Prevention. Reported Tuberculosis in the United States, 2005 [online]. Atlanta, GA: U.S. Department of Health and Human Services, CDC; 2006.

—Submitted by Sandy Althomsons, MA, MHS, for the Surveillance Team
Div of TB Elimination

Update on Research Priorities of the Tuberculosis Epidemiologic Studies Consortium

The Semiannual TBESC Advisory Review (STAR) is the new process for making funding requests to DTBE for Tuberculosis Epidemiologic Studies Consortium (TBESC) research. It is being implemented for the first time in fiscal year (FY) 2007. As part of this process, the TBESC Research Committee, in collaboration with TBESC member sites, DTBE Branch Chiefs and the Associate Director for Science, and representatives from ACET and NTCA, developed a list of research questions based on programmatically relevant priorities in TB prevention and control. After an initial ranking of the research questions (using a formal voting scheme), a conference call was held to share perspectives on the ranked list of questions. This included a discussion of ongoing research, in order to avoid duplication, and gaps in current knowledge. The outcome of the call was a re-voting and a final prioritized list of questions. The prioritized list is intended to provide guidance to TBESC and CDC investigators as they develop research proposals in response to a request for applications issued by DTBE for FY07 funds.

The top five research questions listed in priority order are as follows:

  1. What are the most important risk factors for TB among African Americans?
  2. What is the epidemiology of diabetes and TB (incidence/prevalence)?  What are the treatment outcomes of persons with TB and diabetes, and do the outcomes differ from nondiabetics with TB?
  3. Conduct a study of follow-ups on (1) new arrivals with Class A and B, and (2) those who were placed on a multidrug TB regimen abroad and come to U.S.
  4. Conduct phase 4 surveillance of QFT implementation in program settings: ability of QFT to define populations who will get sick with TB.
  5. Which specific contact investigation (CI) strategies—from the CI guidelines or elsewhere—decrease secondary cases and increase the proportion of infected or at-risk contacts who accept and complete treatment of LTBI?

The research proposals developed in response to the prioritized list of questions were due December 20, 2006. A face-to-face meeting of the DTBE branch chiefs, ADS, and Director, the TBESC Research Committee, and a representative from ACET and NTCA was held January 12, 2007. The purpose of the meeting was to discuss and rank the proposals. The outcome will be a final ranking and funding recommendation to Dr. Ken Castro. The list of priorities will be re-examined each year as part of the ongoing STAR process.

—Reported by Rachel Albalak, PhD
Div of TB Elimination


Released October 2008
Centers for Disease Control and Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
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