NYC Reports Continued Decline In Tuberculosis Cases
The number of TB cases reached its fifth consecutive record low in New York City in 2008, the Health Department announced today. A total of 895 cases were reported in 2008 – a 2% decrease from the 914 cases in 2007 and a 78% decrease from the high levels seen in the early 1990s, when the city faced a TB epidemic. Queens experienced an increase, however – and the citywide TB rate is still nearly three times the national rate (11.2 versus 4.2 cases per 100,000 people).
Dr. Chrispin Kambili, the Health Department’s assistant commissioner for TB control, presented the latest New York City data at the third annual World TB Day Community Forum. The Coalition for a TB-Free NYC hosted the event at the Langston Hughes branch of the Queens Public Library. Dr. Kambili was joined by Peter Baldini, Chief Executive Officer of the World Lung Foundation, who gave opening remarks at the forum. The theme was “NYC is Stopping TB.” The World Lung Foundation is a lead agency in the global fight against TB, which remains a devastating problem in much of the developing world, affecting an estimated 9 million people each year and killing more than 1.5 million annually worldwide.
In New York City, where immigrants make up 36% of the population, TB disproportionately affects non-U.S.-born residents. In 2008, immigrants accounted for 76% of the city’s TB cases, and almost half of the patients were people born in China, Mexico, Ecuador, Dominican Republic or Haiti – countries where TB rates remain high.
“Tuberculosis is a winnable battle,” said Dr. Kambili. “We continue to make progress in New York City, even as the disease remains epidemic elsewhere, but we have more work to do. Tuberculosis is preventable and curable, so New Yorkers at risk should not be afraid to get tested. Screening and treatment in the Health Department chest centers are free and no one will ever be asked about immigration status.”
“New York City has long been a model for the rest of the world in TB control,” said Peter Baldini. “The city has shown that with a sound strategy, political will and strong management, tuberculosis can be stopped.”
With 9 million new cases of TB a year globally and more than 1.5 million deaths annually, the TB epidemic is far from over. “No place in the world is safe from tuberculosis,” Peter Baldini said. “Although 80 percent of cases are concentrated in 22 developing countries, we are combating an airborne enemy that honors no boundaries. This is why we join with colleagues worldwide today, globally and locally, to recommit ourselves to the fight against TB. With our joint commitment, we can reverse the tide against this global menace.”
Tuberculosis by the boroughs
TB case rates declined in Manhattan (by 15%), Brooklyn (7%) and the Bronx (5%) in 2008 (see chart). The number of cases remained stable in Staten Island.
But Queens, home to many immigrants, experienced a 12% increase in TB cases in 2008, after a decline the previous year. The Health Department is working closely with community partners in Queens and other boroughs to control TB.
“TB is not a particular racial, ethnic or socioeconomic group’s disease – we all play a role in combating it,” said Monsignor Thomas Healy of Our Lady of Sorrows Church. “Working together, city agencies, community and faith-based organizations, can increase prevention and better control this curable disease.”
“We are a city and a country of immigrants – and this is our strength,” said Dr. Thomas R. Frieden, New York City Health Commissioner. “But because we are all connected by the air we breathe, it is critical that countries around the globe invest in the TB control measures that work. Working to identify cases and ensuring that everyone gets the right treatment protects us all.”
In response to an ongoing cluster of TB cases in Harlem and the South Bronx since 2003, totaling 48 cases to date, the Health Department plans to launch an educational poster campaign titled “You Can Help Stop TB in New York City.” Designed to look like a comic strip, these posters will urge people who may have been exposed to the ongoing cluster to get a free TB test if they have symptoms of TB disease. In 2008, there were three cases associated with this cluster.
Drug-Resistant TB in New York City
Multidrug-resistant tuberculosis (MDR-TB) refers to TB that is resistant to the most effective medications, making it difficult to cure. The number of MDR-TB cases in New York City remained the same as last year, at nine cases. New cases of MDR-TB have declined 98% since the early 1990s due to better case management and infection control. Last year the city had just two cases of extensively drug-resistant tuberculosis (XDR-TB), which is resistant to even more drugs than MDR-TB.
Tuberculosis is a bacterial infection that spreads from person to person through the air. The infection can remain latent for many years before causing active disease, usually in the lungs. When people who are sick with TB cough or speak, they expel TB germs into the air. Other people may breathe in the TB germs, and some may become sick.
Brief contact with people who are sick with TB (on a train or bus, for example) is unlikely to cause infection. TB is not spread by shaking hands, sharing food or having sex. The infection is usually spread through close, daily contact.
Most people don’t know they have TB infection until they become sick. People at high risk can stop TB by getting themselves tested and taking treatment to prevent TB disease.
Who should get tested for TB:
* People who have symptoms of active TB (coughing, sweating, fatigue, weight loss, fever)
* People who have spent a long time with someone who has active TB disease (a family member, friend, or co-worker)
* People who have recently come from or traveled to a country with a high rate of TB
* People who have HIV infection, lowered immunity, or certain medical conditions such as diabetes or chronic kidney failure
* People who have worked or lived in a homeless shelter, prison or other group setting