Influenza Virus Mashup

Influenza Virus Mashup

Archive for March, 2011

(Fri, 25 Mar 2011 10:30:00 +0000)

 

 

 

# 5444

 

image

Photo credit IAEA

 

Yesterday it was widely reported that 3 nuclear plant workers were exposed to high levels of radiation from water they were wading through in the #3 reactor building (see Fukushima IAEA Updates: March 24th).

 

Today we’ve two follow up reports from NHK World News.

First a report that details the amount of radiation detected in the water in reactor building #3. 

 

TEPCO has measured 3.9 million becquerels of radioactive substances per cubic centimeter, including 2.2 million becquerels of radioactive cerium-144 and 1.2 million becquerels of iodine-131.

 

That’s a level of radioactivity 10,000 times higher than would normally be expected.  

 

High radiation detected in water at plant

Friday, March 25, 2011 08:22 +0900 (JST)

 

Tokyo Electric Power Company says it has detected high levels of radioactive substances in water that 3 workers were exposed to at the troubled Fukushima Daiichi nuclear power plant.

(Continue . . . )

 

 Next a statement to the press by Japan’s Nuclear Safety Agency that suggests that the containment function around reactor #3 is `likely damaged’, leading to the excessive radiation in the report above.

 

 

 

Nuke safety agency: No.3 reactor likely be damaged 

Friday, March 25, 2011 12:48 +0900 (JST)

Japan’s nuclear safety agency says it is highly likely that the Number 3 reactor of the troubled Fukushima Daiichi nuclear power plant has been damaged, leading to the leak of high levels of radiation.

(Continue . . . )

(Fri, 25 Mar 2011 09:50:00 +0000)

 

 

 

# 5443

 

 

image

Voluntary evacuation urged in the red shaded zone.

Graphic NHK World News 

 

 

 

Chief Cabinet Secretary Yukio Edano told reporters today that residents living between 20km and 30km of the damaged Fukushima reactor should consider voluntary evacuation at this time to avoid further hardship.

 

Citing severe living conditions brought on - in part - due to harsh disruptions of essential services and breaks in the local supply/distribution chain, he urged those who have remained in the `stay indoors’ zone for the past two weeks to consider leaving.

 

He also stated that depending upon radiation levels, the government could extend the mandatory evacuation zone in the coming days.

 

 

NHK World News has an article and a video report on this story at:

 

Edano: Voluntary evacuation from 20-30 km advised

Friday, March 25, 2011 13:17 +0900 (JST)

[Crof's H5N1] Mexico: Is it H1N1 in Juarez, or something else?

Posted by Automator On March - 25 - 2011

Via El Heraldo de ChihuahuaEn unas horas confirmarán si se trata de la AH1N1. [In a few hours, we'll know if it's H1N1] Excerpt, with my translation:

La Secretaría de Salud de Gobierno del Estado descartó que se trate de influenza estacional el virus que causó una neumonía atípica fulminante en un agente de Tránsito en Juárez, donde además están contagiados otros elementos, por lo que se tardarán unas horas más para confirmar que se trata de influenza tipo AH1N1. 

The state Secretariat of Health has rejected the idea that seasonal flu caused the fulminating atypical pneumonia in a Juárez transit agent, as well as other persons, while it waits a few more hours to confirm if it’s dealing with H1N1 influenza.

La dependencia informó que comenzó el análisis de 5 muestras de personas enfermas con neumonía en Juárez, todas agentes de Tránsito, y descartó que se trate de la influenza común. Una de las muestras que se analizan corresponde a una persona que falleció el día martes a consecuencia de una neumonía atípica fulminante.La prueba rápida en laboratorio descartó influenza estacional, igual que en el resto.

The Secretariat reports that it has begun the analysis of samples from five persons in Juárez with pneumonia, all transit agents, and it dismisses the idea that they have seasonal flu. One of the test samples is from a person who died on Tuesday from a fulminating atypical pneumonia. The rapid lab test showed it was not seasonal flu, and the same for the rest.

Meanwhile, via Google News, an EFE report says the Chihuahua state government has declared an “epidemiological alert” over an outbreak of H1N1 that has killed a police officer, infected two others, and put 15 other patients under suspicion of the same infection.

Neither story refers to the other. Maybe the transit people are all down with some form of H1N1 like the police officer, or maybe the city is dealing with two different outbreaks. I hope we’ll find out by tomorrow.

(Thu, 24 Mar 2011 20:50:00 +0000)

 

 

# 5442

 

 

One of the more contentious debates in the world of avian influenza is over exactly what role migratory birds play in the spread of highly pathogenic H5N1.  

 

Bird enthusiasts and naturalists tend to point to the poorly regulated and controlled poultry trade as being the main source of the spread of the bird flu virus, while those in the poultry industry tend to blame migratory birds.

 

Over the years we’ve seen study after study that either implicates migratory birds in the spread of the virus, or minimizes their role.

 

 

Last September (see Another Migratory Bird Study) a paper appeared in the British Ecological Society’s Journal of Applied Ecology, that claimed that the global spread of the H5N1 virus through migratory birds was possible . . . but unlikely.

 

In a blog from 2009, called  India: The Role Of Migratory Birds In Spreading Bird Flu  I wrote about an article entitled  Scientists rule out spreading of bird flu by migrant birds in India  from Xinhua News.

 

And in January of 2008, Reuters carried a report called:

 

Don’t blame wild birds for H5N1 spread: expert

BANGKOK (Reuters) - There is no solid evidence that wild birds are to blame for the apparent spread of the H5N1 virus from Asia to parts of Europe, Africa and the Middle East, an animal disease expert said on Wednesday.

 

There was also no proof that wild birds were a reservoir for the H5N1 virus, Scott Newman, international wildlife coordinator for avian influenza at the U.N.’s Food and Agriculture Organization, said at a bird flu conference in Bangkok.

(Continue . . . )

 

 

Despite these statements to the contrary, there have been plenty of other reports that strongly associate migratory birds with the spread of the virus.

A few include:

 

Korea: Migratory Birds Behind Spread Of H5N1
EID Journal: H5N1 Branching Out
Japan: Hooded Crane Positive For H5N1
Not One Of The Usual Suspects
FAO: On The Trail Of Avian Influenza

 

 

Since I don’t have a bird in this fight, I readily concede that both are probably significant contributing factors in the spread of the virus.

 

I see no reason why they should be mutually exclusive.

 

Which brings us to a study that was recently published in PLoS One  called:

 

 

Wild Bird Migration across the Qinghai-Tibetan Plateau: A Transmission Route for Highly Pathogenic H5N1

Diann J. Prosser, Peng Cui, John Y. Takekawa, Mingjie Tang, Yuansheng Hou, Bridget M. Collins, Baoping Yan, Nichola J. Hill, Tianxian Li, Yongdong Li, Fumin Lei, Shan Guo, Zhi Xing, Yubang He, Yuanchun Zhou, David C. Douglas, William M. Perry, Scott H. Newman

Background

Qinghai Lake in central China has been at the center of debate on whether wild birds play a role in circulation of highly pathogenic avian influenza virus H5N1. In 2005, an unprecedented epizootic at Qinghai Lake killed more than 6000 migratory birds including over 3000 bar-headed geese (Anser indicus). H5N1 subsequently spread to Europe and Africa, and in following years has re-emerged in wild birds along the Central Asia flyway several times.

Methodology/Principal Findings

To better understand the potential involvement of wild birds in the spread of H5N1, we studied the movements of bar-headed geese marked with GPS satellite transmitters at Qinghai Lake in relation to virus outbreaks and disease risk factors.

 

We discovered a previously undocumented migratory pathway between Qinghai Lake and the Lhasa Valley of Tibet where 93% of the 29 marked geese overwintered. From 2003–2009, sixteen outbreaks in poultry or wild birds were confirmed on the Qinghai-Tibet Plateau, and the majority were located within the migratory pathway of the geese. Spatial and temporal concordance between goose movements and three potential H5N1 virus sources (poultry farms, a captive bar-headed goose facility, and H5N1 outbreak locations) indicated ample opportunities existed for virus spillover and infection of migratory geese on the wintering grounds.

 

Their potential as a vector of H5N1 was supported by rapid migration movements of some geese and genetic relatedness of H5N1 virus isolated from geese in Tibet and Qinghai Lake.

Conclusions/Significance

This is the first study to compare phylogenetics of the virus with spatial ecology of its host, and the combined results suggest that wild birds play a role in the spread of H5N1 in this region. However, the strength of the evidence would be improved with additional sequences from both poultry and wild birds on the Qinghai-Tibet Plateau where H5N1 has a clear stronghold.

(Continue . . . )

 

image

 

 

The USGS has released a press statement on this study, (which was funded by USGS, FAO, National Science Foundation and the Chinese Academy of Sciences) that describes the project and the results.

 

New research suggests wild birds may play a role in the spread of bird flu

LAUREL, Md. — Wild migratory birds may indeed play a role in the spread of bird flu, also known as highly pathogenic avian influenza H5N1.

 

A study by the U.S. Geological Survey, the United Nations Food and Agriculture Organization and the Chinese Academy of Sciences used satellites, outbreak data and genetics to uncover an unknown link in Tibet among wild birds, poultry and the movement of the often-deadly virus.

 

Researchers attached GPS satellite transmitters to 29 bar-headed geese – a wild species that migrates across most of Asia and that died in the thousands in the 2005 bird flu outbreak in Qinghai Lake, China. GPS data showed that wild geese tagged at Qinghai Lake spend their winters in a region outside of Lhasa, the capitol of Tibet, near farms where H5N1 outbreaks have occurred in domestic geese and chickens.

 

This is the first evidence of a mechanism for transmission between domestic farms and wild birds, said Diann Prosser, a USGS biologist at the USGS Patuxent Wildlife Research Center. “Our research suggests initial outbreaks in poultry in winter, followed by outbreaks in wild birds in spring and in the breeding season. The telemetry data also show that during winter, wild geese use agricultural fields and wetlands near captive bar-headed geese and chicken farms where outbreaks have occurred.

(Continue . . . )

 

 

Like most scientific studies, this one increments our knowledge, rather than completing it.

 

While falling a bit short of finding a smoking gun, it documents a plausible mechanism for the H5N1 virus to be spread from domesticated poultry to wild birds during the winter, and from there relayed primarily by asymptomatic birds along the migratory pathways. 

The authors conclude by stating:

Our study identifies QHL and Lhasa as important linkages between wild and domestic transmission of H5N1 and provides new supporting information regarding the role of wild birds in long distance spread of this virus.

 

Further investigation of wild birds and H5N1 transmission within the Central Asian Flyway will increase our understanding of how wild birds may contribute to virus circulation and the unique pattern of outbreaks in this remote region.

[Avian Flu Diary] Fukushima IAEA Updates: March 24th

Posted by Automator On March - 25 - 2011

(Thu, 24 Mar 2011 18:16:00 +0000)

 

 

# 5441

 

 

The IAEA has posted as series of updates on the Fukushima nuclear reactors on their website and their Facebook Page.

 

 

You can view the most recent updates at:

Fukushima Nuclear Accident Update Log

 

Table: Summary of reactor unit status at of 24 March-0600 UTC

image 

 

 

 

Fukushima Daiichi Nuclear Accident Update (24 March, 17:30 UTC)

Japanese Seawater Samples Show Signs of Radioactive Materials

Japanese authorities today provided the IAEA with data on seawater samples they collected on 22 and 23 March, after detecting iodine and cesium in the water near the Fukushima Daiichi nuclear power plant. (See earlier update.)

 

A vessel from the Japan Agency for Marine-Earth Science and Technology (JAMSTEC) collected water samples at several points 30 kilometres from the coastline and found measurable concentrations of iodine-131 and cesium-137.

The iodine concentrations were at or above Japanese regulatory limits, and the cesium levels were well below those limits.

 

The IAEA’s Marine Environmental Laboratory in Monaco has received the data for review.

 

Fukushima Daiichi Nuclear Accident Update (24 March 17:25 UTC)

Japanese Workers Treated for Radiation Exposure

Japanese authorities today reported that three workers at the Fukushima Daiichi nuclear power plant were exposed to elevated levels of radiation. The three were working in the turbine building of reactor Unit 3 and have received a radiation dose in the range of 170-180 millisieverts.

Two of the workers have been hospitalized for treatment of severely contaminated feet, which may have suffered radiation burns. The workers had been working for about three hours in contact with contaminated water.

 

Fukushima Daiichi Nuclear Accident Update (24 March 2011, 14:00 UTC)

by International Atomic Energy Agency (IAEA) on Thursday, March 24, 2011 at 10:29am

Spent Fuel Pools at Fukushima Daiichi Nuclear Power Plant - Updated

Spent fuel removed from a nuclear reactor is highly radioactive and generates heat. This irradiated fuel needs to be stored for one to three years in pools that cool the fuel, shield the radioactivity, and keep the fuel in the proper position to avoid fission reactions. If the cooling is lost, the water can boil and fuel rods can be exposed to the air, possibly leading to severe damage and a large release of radioactive materials.

 

Nuclear power plants must replace fuel every one to two years, and the Fukushima Daiichi reactors typically remove about 25 percent of the reactor’s fuel — to be replaced with fresh, or unirradiated, fuel — during each refuelling outage. The spent fuel, which is hottest immediately after it is removed from the reactor, is placed in the spent fuel pool until it is cool enough to be moved to longer-term storage.

 

The concern about the spent fuel pools at Fukushima Daiichi is that the capability to cool the pools has been compromised. See diagram below for location of the pool in each reactor building.

For more, see…http://www.iaea.org/newscenter/news/tsunamiupdate01.html

 

[Avian Flu Diary] MMWR: Tuberculosis Trends In The United States

Posted by Automator On March - 24 - 2011

(Thu, 24 Mar 2011 17:05:00 +0000)

 

# 5439

 

 

Today’s MMWR from the CDC, released on this World TB Day, contains two reports on the incidence of Tuberculosis in the United States.

 

I’ve pulled some excerpts from each report (and reformatted for readability), but follow the links to read them in their entirety.

 

The first takes a closer look at an unexpected drop in TB cases in two states – Georgia and Pennsylvania – in 2009, and concludes that these reductions were real, and not the result of surveillance artifacts, health-care provider under diagnoses, or underreporting.

 

Assessment of Declines in Reported Tuberculosis Cases — Georgia and Pennsylvania, 2009


Weekly

March 25, 2011 / 60(11);338-342

image

What is already known on this topic?

In 2009, tuberculosis (TB) incidence in the United States decreased to 3.8 cases per 100,000 population, the lowest recorded rate since national TB surveillance began in 1953. The 11.4% decrease from 2008 was the greatest single-year decrease ever recorded.

What is added by this report?

Findings from systematic investigations in Georgia and Pennsylvania, two states that experienced unexpectedly large decreases in TB incidence in 2009, indicate that the decline in new TB disease in those states appeared actual and not attributable to surveillance artifact, health-care provider underdiagnosis, or underreporting.

What are the implications for public health practice?

The TB surveillance systems in Georgia and Pennsylvania appear to be functioning appropriately. Current efforts to diagnose, treat, and report TB cases should be vigorously maintained as the United States moves closer to the goal of TB elimination.

 

 

The second report looks at the trends in Tuberculosis in the United States, and finds that while significant reductions in TB have been made, the stated goal back in 1989 of reaching an incidence rate of < 0.1 per 100,000 population by 2010 has not been met.

 

Trends in Tuberculosis — United States, 2010


Weekly

March 25, 2011 / 60(11);333-337

In 2010, a total of 11,181 tuberculosis (TB) cases were reported in the United States, for a rate of 3.6 cases per 100,000 population, which was a decline of 3.9% from 2009 and the lowest rate recorded since national reporting began in 1953 (1). This report summarizes provisional 2010 data from the National TB Surveillance System and describes trends since 1993.

 

Despite an average decline in TB rates of 3.8% per year during 2000–2008, a record decline of 11.4% in 2009 (2), and the 2010 decline of 3.9%, the national goal of TB elimination (defined as <0.1 case per 100,000 population) by 2010 was not met (3).

 

Although TB cases and rates decreased among foreign-born and U.S.-born persons, foreign-born persons and racial/ethnic minorities were affected disproportionately by TB in the United States. In 2010, the TB rate among foreign-born persons in the United States was 11 times greater than among U.S.-born persons.

 

TB rates among Hispanics, non-Hispanic blacks, and Asians were seven, eight, and 25 times greater, respectively, than among non-Hispanic whites. Among U.S.-born racial and ethnic groups, the greatest racial disparity in TB rates was for non-Hispanic blacks, whose rate was seven times greater than the rate for non-Hispanic whites.

 

Progress toward TB elimination in the United States will require ongoing surveillance and improved TB control and prevention activities to address persistent disparities between U.S.-born and foreign-born persons and between whites and minorities.

FIGURE 1. Rate* of tuberculosis (TB) cases, by state/area — United States, 2010

The figure shows the rate of tuberculosis (TB) cases, by state/area in the United States in 2010. In 2010, a total of 11,181 tuberculosis (TB) cases were reported in the United States, equivalent to a rate of 3.6 cases per 100,000 population. TB rates in reporting areas ranged from 0.6 (Maine) to 8.8 (Hawaii) cases per 100,000 population (median: 2.5).

Source: National TB Surveillance System.

* Per 100,000 population.

† Provisional data as of February 26, 2011.

§ 20 states had TB case rates <2.0 (range: 0.61–1.88) per 100,000

What is already known on the topic?

In 1989, the Strategic Plan for Elimination of Tuberculosis in the United States set a target date of 2010 to achieve its goal, defined as an annual tuberculosis (TB) case rate of <0.1 per 100,000 population.

 

What is added by this report?

For 2010, preliminary data show a national TB case rate of 3.6 per 100,000 population, a decrease of 3.9% from 2009, but the goal of eliminating TB in the United States by 2010 was not achieved, and foreign-born persons and racial/ethnic minorities continued to be affected disproportionately.

 

What are the implications for public health practice?

Ongoing surveillance and improved TB control and prevention activities, especially among disproportionately affected populations, are needed to eliminate TB in the United States.

[Avian Flu Diary] MMWR: Tuberculosis Trends In The United States

Posted by Automator On March - 24 - 2011

(Thu, 24 Mar 2011 17:05:00 +0000)

 

# 5439

 

 

Today’s MMWR from the CDC, released on this World TB Day, contains two reports on the incidence of Tuberculosis in the United States.

 

I’ve pulled some excerpts from each report (and reformatted for readability), but follow the links to read them in their entirety.

 

The first takes a closer look at an unexpected drop in TB cases in two states – Georgia and Pennsylvania – in 2009, and concludes that these reductions were real, and not the result of surveillance artifacts, health-care provider under diagnoses, or underreporting.

 

Assessment of Declines in Reported Tuberculosis Cases — Georgia and Pennsylvania, 2009


Weekly

March 25, 2011 / 60(11);338-342

image

What is already known on this topic?

In 2009, tuberculosis (TB) incidence in the United States decreased to 3.8 cases per 100,000 population, the lowest recorded rate since national TB surveillance began in 1953. The 11.4% decrease from 2008 was the greatest single-year decrease ever recorded.

What is added by this report?

Findings from systematic investigations in Georgia and Pennsylvania, two states that experienced unexpectedly large decreases in TB incidence in 2009, indicate that the decline in new TB disease in those states appeared actual and not attributable to surveillance artifact, health-care provider underdiagnosis, or underreporting.

What are the implications for public health practice?

The TB surveillance systems in Georgia and Pennsylvania appear to be functioning appropriately. Current efforts to diagnose, treat, and report TB cases should be vigorously maintained as the United States moves closer to the goal of TB elimination.

 

 

The second report looks at the trends in Tuberculosis in the United States, and finds that while significant reductions in TB have been made, the stated goal back in 1989 of reaching an incidence rate of < 0.1 per 100,000 population by 2010 has not been met.

 

Trends in Tuberculosis — United States, 2010


Weekly

March 25, 2011 / 60(11);333-337

In 2010, a total of 11,181 tuberculosis (TB) cases were reported in the United States, for a rate of 3.6 cases per 100,000 population, which was a decline of 3.9% from 2009 and the lowest rate recorded since national reporting began in 1953 (1). This report summarizes provisional 2010 data from the National TB Surveillance System and describes trends since 1993.

 

Despite an average decline in TB rates of 3.8% per year during 2000–2008, a record decline of 11.4% in 2009 (2), and the 2010 decline of 3.9%, the national goal of TB elimination (defined as <0.1 case per 100,000 population) by 2010 was not met (3).

 

Although TB cases and rates decreased among foreign-born and U.S.-born persons, foreign-born persons and racial/ethnic minorities were affected disproportionately by TB in the United States. In 2010, the TB rate among foreign-born persons in the United States was 11 times greater than among U.S.-born persons.

 

TB rates among Hispanics, non-Hispanic blacks, and Asians were seven, eight, and 25 times greater, respectively, than among non-Hispanic whites. Among U.S.-born racial and ethnic groups, the greatest racial disparity in TB rates was for non-Hispanic blacks, whose rate was seven times greater than the rate for non-Hispanic whites.

 

Progress toward TB elimination in the United States will require ongoing surveillance and improved TB control and prevention activities to address persistent disparities between U.S.-born and foreign-born persons and between whites and minorities.

FIGURE 1. Rate* of tuberculosis (TB) cases, by state/area — United States, 2010

The figure shows the rate of tuberculosis (TB) cases, by state/area in the United States in 2010. In 2010, a total of 11,181 tuberculosis (TB) cases were reported in the United States, equivalent to a rate of 3.6 cases per 100,000 population. TB rates in reporting areas ranged from 0.6 (Maine) to 8.8 (Hawaii) cases per 100,000 population (median: 2.5).

Source: National TB Surveillance System.

* Per 100,000 population.

† Provisional data as of February 26, 2011.

§ 20 states had TB case rates <2.0 (range: 0.61–1.88) per 100,000

What is already known on the topic?

In 1989, the Strategic Plan for Elimination of Tuberculosis in the United States set a target date of 2010 to achieve its goal, defined as an annual tuberculosis (TB) case rate of <0.1 per 100,000 population.

 

What is added by this report?

For 2010, preliminary data show a national TB case rate of 3.6 per 100,000 population, a decrease of 3.9% from 2009, but the goal of eliminating TB in the United States by 2010 was not achieved, and foreign-born persons and racial/ethnic minorities continued to be affected disproportionately.

 

What are the implications for public health practice?

Ongoing surveillance and improved TB control and prevention activities, especially among disproportionately affected populations, are needed to eliminate TB in the United States.

[Crof's H5N1] Indonesia: Suspected H5N1 patient dies

Posted by Automator On March - 24 - 2011

Via Ida’s Bird Flu Information Corner, a translated report from KompasGunungkidul, Yogyakarta ::: A dead patient suspected of contracting bird flu. Excerpt:

A 26-year-old female named Sri Supartilah, a resident of Desa Pacarejo, Semanu, Gunungkidul died after being treated for 3 days in Sardjito hospital, Yogyakarta on Wednesday, 23 March. Patient who was a housewife, is suspected of contracting avian influenza (H5N1) infection. 

Head of Health Service Kabupaten Gunungkidul, dr. Sri Raharto, said the cause of death is still unknown. Currently, confirmation test is undergoing by Ministry of Health.

Ida also reports today on B2B H5N1 spreading in three municipalities in Bali.

[Crof's H5N1] Indonesia: Suspected H5N1 patient dies

Posted by Automator On March - 24 - 2011

Via Ida’s Bird Flu Information Corner, a translated report from KompasGunungkidul, Yogyakarta ::: A dead patient suspected of contracting bird flu. Excerpt:

A 26-year-old female named Sri Supartilah, a resident of Desa Pacarejo, Semanu, Gunungkidul died after being treated for 3 days in Sardjito hospital, Yogyakarta on Wednesday, 23 March. Patient who was a housewife, is suspected of contracting avian influenza (H5N1) infection. 

Head of Health Service Kabupaten Gunungkidul, dr. Sri Raharto, said the cause of death is still unknown. Currently, confirmation test is undergoing by Ministry of Health.

Ida also reports today on B2B H5N1 spreading in three municipalities in Bali.

[Avian Flu Diary] MMWR: Tuberculosis Trends In The United States

Posted by Automator On March - 24 - 2011

(Thu, 24 Mar 2011 17:05:00 +0000)

 

# 5439

 

 

Today’s MMWR from the CDC, released on this World TB Day, contains two reports on the incidence of Tuberculosis in the United States.

 

I’ve pulled some excerpts from each report (and reformatted for readability), but follow the links to read them in their entirety.

 

The first takes a closer look at an unexpected drop in TB cases in two states – Georgia and Pennsylvania – in 2009, and concludes that these reductions were real, and not the result of surveillance artifacts, health-care provider under diagnoses, or underreporting.

 

Assessment of Declines in Reported Tuberculosis Cases — Georgia and Pennsylvania, 2009


Weekly

March 25, 2011 / 60(11);338-342

image

What is already known on this topic?

In 2009, tuberculosis (TB) incidence in the United States decreased to 3.8 cases per 100,000 population, the lowest recorded rate since national TB surveillance began in 1953. The 11.4% decrease from 2008 was the greatest single-year decrease ever recorded.

What is added by this report?

Findings from systematic investigations in Georgia and Pennsylvania, two states that experienced unexpectedly large decreases in TB incidence in 2009, indicate that the decline in new TB disease in those states appeared actual and not attributable to surveillance artifact, health-care provider underdiagnosis, or underreporting.

What are the implications for public health practice?

The TB surveillance systems in Georgia and Pennsylvania appear to be functioning appropriately. Current efforts to diagnose, treat, and report TB cases should be vigorously maintained as the United States moves closer to the goal of TB elimination.

 

 

The second report looks at the trends in Tuberculosis in the United States, and finds that while significant reductions in TB have been made, the stated goal back in 1989 of reaching an incidence rate of < 0.1 per 100,000 population by 2010 has not been met.

 

Trends in Tuberculosis — United States, 2010


Weekly

March 25, 2011 / 60(11);333-337

In 2010, a total of 11,181 tuberculosis (TB) cases were reported in the United States, for a rate of 3.6 cases per 100,000 population, which was a decline of 3.9% from 2009 and the lowest rate recorded since national reporting began in 1953 (1). This report summarizes provisional 2010 data from the National TB Surveillance System and describes trends since 1993.

 

Despite an average decline in TB rates of 3.8% per year during 2000–2008, a record decline of 11.4% in 2009 (2), and the 2010 decline of 3.9%, the national goal of TB elimination (defined as <0.1 case per 100,000 population) by 2010 was not met (3).

 

Although TB cases and rates decreased among foreign-born and U.S.-born persons, foreign-born persons and racial/ethnic minorities were affected disproportionately by TB in the United States. In 2010, the TB rate among foreign-born persons in the United States was 11 times greater than among U.S.-born persons.

 

TB rates among Hispanics, non-Hispanic blacks, and Asians were seven, eight, and 25 times greater, respectively, than among non-Hispanic whites. Among U.S.-born racial and ethnic groups, the greatest racial disparity in TB rates was for non-Hispanic blacks, whose rate was seven times greater than the rate for non-Hispanic whites.

 

Progress toward TB elimination in the United States will require ongoing surveillance and improved TB control and prevention activities to address persistent disparities between U.S.-born and foreign-born persons and between whites and minorities.

FIGURE 1. Rate* of tuberculosis (TB) cases, by state/area — United States, 2010

The figure shows the rate of tuberculosis (TB) cases, by state/area in the United States in 2010. In 2010, a total of 11,181 tuberculosis (TB) cases were reported in the United States, equivalent to a rate of 3.6 cases per 100,000 population. TB rates in reporting areas ranged from 0.6 (Maine) to 8.8 (Hawaii) cases per 100,000 population (median: 2.5).

Source: National TB Surveillance System.

* Per 100,000 population.

† Provisional data as of February 26, 2011.

§ 20 states had TB case rates <2.0 (range: 0.61–1.88) per 100,000

What is already known on the topic?

In 1989, the Strategic Plan for Elimination of Tuberculosis in the United States set a target date of 2010 to achieve its goal, defined as an annual tuberculosis (TB) case rate of <0.1 per 100,000 population.

 

What is added by this report?

For 2010, preliminary data show a national TB case rate of 3.6 per 100,000 population, a decrease of 3.9% from 2009, but the goal of eliminating TB in the United States by 2010 was not achieved, and foreign-born persons and racial/ethnic minorities continued to be affected disproportionately.

 

What are the implications for public health practice?

Ongoing surveillance and improved TB control and prevention activities, especially among disproportionately affected populations, are needed to eliminate TB in the United States.