Philip LoBue, M.D., FACP, FCCP
Director, Division of Tuberculosis Elimination, U.S. Centers for Disease Control and Prevention (CDC)
New preliminary data released by the Centers for Disease Control and Prevention show that the number of tuberculosis (TB) cases in the United States declined from 9,021 cases in 2018 to 8,920 cases in 2019 — the fourth straight year the total number of cases has decreased and the lowest number recorded in U.S. history.
That’s good news, but not good enough. At CDC, we’re working with partners across the country to ramp up TB prevention and control efforts on several fronts to eliminate the disease entirely in the United States.
A dual approach
The United States is a leader in controlling TB disease thanks to ongoing investments in our public health system, yet too many Americans are still affected by this severe, sometimes deadly disease. To accelerate progress toward elimination, CDC supports a dual approach that includes diagnosing and treating every case of TB disease and preventing future cases by expanding testing and treatment for people with latent TB infection (LTBI).
People with LTBI do not feel sick, do not show symptoms of TB disease, and cannot spread the bacteria to others. However, without treatment, the bacteria can become active, which causes TB disease. For this reason, CDC recommends treatment and testing for people with LTBI as part of routine primary healthcare for people at risk.
Up to 13 million people in the United States have LTBI and most do not know it. More than 80 percent of U.S. TB cases result from untreated LTBI.
A new generation of solutions
Current treatment regimens for TB involve daily medication, which can cause serious side effects. Yet, treating LTBI has fewer side effects, costs less, and is less difficult than treating TB disease.
Last month, CDC and the National TB Controllers Association released new LTBI treatment guidelines that preferentially recommend shorter (three- to four-month, rather than six- to nine-month) treatments for most people living in the United States. Unfortunately, many U.S. healthcare providers are unaware of these options and the benefits they provide to individual patients and overall public health.
The new guidelines equip healthcare providers with updated information to treat LTBI in order to prevent the disease from developing in a patient.
Working together to end TB
Broader partnerships are needed to strengthen TB control efforts in the United States, and we’re working with national, state, and local partners to get the right TB treatments out to the right communities. This includes working with healthcare providers, who are on the front lines in the fight against LTBI. They play a key role in expanding testing and treatment.
CDC encourages healthcare providers to use newer TB blood tests to screen for LTBI and prescribe shorter treatments for LTBI to prevent the development of TB disease.
The path to eliminating TB in the United States is clear. With improved TB tests and new guidelines that encourage shorter LTBI treatment regimens, we have a greater opportunity than ever to end this deadly disease in our country.