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TB Notes 2, 2006
Highlights from State and Local Programs
  An Outbreak Response in a Rural, Southwest Missouri County Jail
  No Reported TB Cases in Wyoming in 2005
  Suffolk County (New York) Targeted TB Testing and Treatment Program Among the Foreign-born, 2000–2004
  The Changing Epidemiology of TB in Connecticut, 2000-2004
  Molecular Genotyping of Mycobacterium tuberculosis in Connecticut
  Third Annual Conference on TB in the U.S. Pacific Islands: Meeting Highlights, Challenges, and Solutions for Addressing the Disparities
  "Update: Tuberculosis Nursing" Workshop in Hawaii
  Lessons Learned in the Process of Evaluation – Illinois
  TB Education and Targeted Testing of Garfield County, Colorado, WIC Clients
Laboratory Updates
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Communications, Education, and Behavioral Studies Branch Updates
Information Technology and Statistics Branch Update
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TB Notes Newsletter

No. 2, 2006


Enhanced Surveillance to Identify Missed Opportunities for TB Prevention in the Foreign-born: Closing the Gap

A CDC-funded study in the United States and Canada that is aimed at closing the gap in TB incidence between native-born and foreign-born persons began in April. Its purposes are to (1) describe the epidemiology of TB in foreign-born persons in the United States and Canada, (2) identify missed opportunities to prevent development and transmission of TB in foreign-born persons, and (3) make recommendations for program improvements at the national, state or provincial, and local levels. To date, study researchers have conducted almost 1,300 of a planned 1,500 interviews with foreign-born persons newly diagnosed with TB.

The study involves all 21 sites of the Tuberculosis Epidemiologic Studies Consortium (TBESC) in 17 states and two Canadian provinces. The TBESC was established in September 2001 to conduct TB research and to strengthen TB public health infrastructure in the United States and Canada. The sites include academic institutions, medical centers, and TB control programs. TBESC has 16 research projects underway.

TBESC selected the epidemiology of TB in foreign-born persons as a top research priority because of its critical importance to TB elimination in the United States and Canada. In the past decade, TB case numbers and rates in North America have dropped faster among native-born persons compared to foreign-born persons. The result has been a growing gap in TB incidence between the two groups. In 2003, the TB rate among foreign-born persons in the United States (23.6 per 100,000) was almost nine times higher than the rate among native-born persons (2.7 per 100,000); foreign-born persons accounted for 53% of the 14,874 TB cases reported in the United States.†

This is the first large population-based epidemiologic study of TB in foreign-born persons in the United States and Canada. To prepare for the study, TBESC researchers developed and pilot-tested an hour-long questionnaire that asks participants about their socioeconomic status, immigration and travel history, history of TB symptoms and care sought for those symptoms, previous treatment and testing for TB, and knowledge and attitudes about TB. The questionnaire has been translated into 10 languages. It will be supplemented with clinical data on each participant that is routinely collected and reported to the CDC and Health Canada.

Researchers will enter the data into a Web-based data entry system developed for the study that can also be adapted to other TBESC studies.†

Data collection will be completed in 2006. These data will be used to identify interventions that can improve basic TB control activities and inform public health efforts to eliminate TB in the United States and Canada.

óReported by Dolly Katz, PhD
Div of TB Elimination

Surveillance Team Update

The primary goal of the Surveillance Team is to maintain a high-quality National Tuberculosis Surveillance System and to enhance the dissemination and use of surveillance data in collaboration with health departments. Following is an update on some of the surveillance teamís current activities:

  • OTIS, the Online Tuberculosis Information System, is now online and available to the public. Users can request tabular counts and percentages for 22 selected RVCT variables and rates for national demographic data. The system can be accessed by going to or at, then selecting Online Tuberculosis Information System.
  • The National Surveillance System for Severe Adverse Events Associated with Treatment of Latent TB Infection is underway. DTBE urges health care providers and health departments to report all severe adverse events (e.g., liver injury, metabolic acidosis, anaphylaxis, seizure, severe dermatitis) leading to hospitalization or death of a person receiving any treatment for LTBI that occurred after January 1, 2004. Please report by telephone: 404-639-8401 or e-mail:
  • In conjunction with World TB Day on March 24, 2006, DTBE released an MMWR article on 2005 provisional surveillance data. The annual report, Reported Tuberculosis in the United States, 2005, with final 2005 data, will be ready for distribution in December 2006. DTBE is soliciting input on ways to enhance the dissemination and use of the surveillance report. Please send your suggestions to

óReported by Lilia Manangan and Glenda Newell
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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