Atlanta – Tuberculosis in the United States hit an all-time low last year, but health officials say they are wary of a continuing trickle of foreign cases of dangerous drug-resistant TB.
There were about 4.6 cases of tuberculosis for every 100,000 Americans, a total of 13,767 cases in 2006, the U.S. Centers for Disease Control and Prevention reported Thursday.
The TB rate in the U.S. has been falling for years. But hidden in the good news are some disturbing rises in TB cases in some states, as well as the continued appearance of a form of the disease that is resistant to both the first- and second-line antibiotics.
Twenty states saw more cases from 2005 to 2006. The biggest jumps were in Texas, which reported 50 more cases than in the previous year, and North Carolina, which had 45 more.
“That to me is unacceptable, said Dr. Kenneth Castro, director of the CDC’s Division of Tuberculosis Elimination.
For more than a decade, health officials have worried about “multidrug-resistant” TB, which can withstand the mainline antibiotics isoniazid and rifampin. About 1.2 percent of U.S. TB cases fall into that category, according to CDC statistics.
Last year two cases were of the more problematic category of “extensively drug-resistant TB.” XDR-TB, as it is known, does not respond to at least three of six classes of second- line drugs.
That is especially worrisome, because second-line drugs are generally considered more toxic and less effective. Medical treatment of just one case of XDR-TB can cost $500,000 or more, Castro said. One case that made recent headlines was a Russian man who arrived in Phoenix last year. He was jailed after he stopped taking medications and went unmasked to a Jack in the Box restaurant and other businesses, threatening the health of others.
