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Tuberculosis rising after pandemic-era decline; NY caseload 40% higher than national rate
By
Caroline Lewis
Published Mar 23, 2023
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By
Caroline Lewis
Published Mar 23, 2023
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Tuberculosis is rising in the U.S. and New York is among the states that witnessed an increase in cases last year, according to new data from the U.S. Centers for Disease Control and Prevention. The numbers show that New York’s caseload in 2022 was about 40% higher than the national rate.
TB is still less common in the U.S. than it was 10 years ago, with fewer than three cases per 100,000 people nationwide. But the infection rate is rebounding after dipping during the COVID-19 pandemic, and some experts are worried.
“The message is loud and clear – TB is still here,” Dr. Philip LoBue, director of the CDC’s Division of Tuberculosis Elimination, said in a statement. “For the second year in a row, TB cases have continued to rise, with concerning increases among young children and other groups at risk for TB disease.”
Tuberculosis, a bacteria that attacks the lungs, is less of a concern in New York now than it was in the early 20th century when it went by the name “consumption” and was a leading cause of death. A combination of antibiotics, early detection, vaccination, better hygiene and public health practices brought TB under control in the U.S. and prevented fatalities, but the germ never fully went away here or globally.
Unlike in some parts of the world, the number of TB cases in New York dipped early in the COVID-19 pandemic and still hasn’t returned to pre-pandemic levels. But the number of cases in New York has started to creep back up over the past three years – from 605 in 2020 to 683 in 2021, according to the CDC. In 2022, New York recorded 714 cases of tuberculosis – a rate of 3.6 cases per 100,000 people. Compare that against the rate of 2.5 cases per 100,000 people nationwide.
U.S. tuberculosis cases and incidence by birth origin, 2012–2022.
CDC
In New York City, which has the majority of the state’s TB, the rate is even higher. Last year, the five boroughs experienced 536 cases, for a rate of 6.1 per 100,000 people, according to city data. That’s more than double the national rate. Of these, 88% of cases were registered among people born outside of the U.S., with 55 different countries represented. Every single city neighborhood had at least one case of TB.
Those with HIV and other immune disorders are at much higher risk for contracting the disease than the general population, according to the CDC. It also disproportionately affects people experiencing homelessness because of higher rates of diseases such as HIV and issues such as shelter crowding, the agency explained.
The city health department offers a set of questions for New Yorkers to assess the likelihood that they have TB.
While TB mostly afflicts the lungs, the bacteria can also be found in other parts of the body such as the kidneys, spine or brain, according to the CDC. When TB bacteria settles in the lungs, it can spread through the air when someone coughs or speaks. But it doesn’t spread through other means such as touch or sharing a drink. It’s usually not infectious when it resides in parts of the body other than the lungs, according to the CDC.
TB can be detected through a skin or blood test and is typically treated with several months of antibiotics. Some people become infected with TB without becoming sick or spreading it to others.
But without treatment, about 5% to 10% of infected people will develop TB symptoms in their lifetimes, according to the World Health Organization and CDC.
About half will experience those symptoms within the first two years, while the rest can take decades to develop what’s known as a latent infection. The CDC estimates about 13 million people in the U.S. have latent TB.
Those who do get sick experience symptoms such as a long-lasting bad cough, fever, chills, or coughing up blood or sputum, according to the CDC. The World Health Organization states that, without proper treatment, “45% of HIV-negative people with TB on average and nearly all HIV-positive people with TB will die.”
Friday is World TB Day.
Tagged
new york state
Health and Science
tuberculosis
Caroline Lewis
Caroline Lewis is on the health care beat for WNYC and Gothamist. She has covered COVID, a nurses' strike, the overdose crisis and New York’s marijuana legalization effort, and spent a year investigating patients' medical bills. She always wants to hear about how everyday New Yorkers experience the health system. Got a tip? Email [email protected].
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