MMWR News Synopsis for March 23, 2017

Trends in Tuberculosis – 2016

National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
404-639-8895
NCHHSTPMediaTeam@cdc.gov

Tuberculosis (TB) remains under control in the U.S., but preliminary 2016 data indicate current progress is too slow to eliminate TB in the foreseeable future, or even this century. Preliminary data from CDC’s National TB Surveillance System reports a total of 9,287 U.S. TB cases in 2016, indicating slight declines in TB cases (-2.7%) and TB rates (-3.4%) over 2015. The preliminary data bring the overall annual TB incidence for 2016 down slightly over 2015 to approximately 2.9 cases per 100,000 persons. Epidemiologic modeling suggests that if this slow rate of decline continues, it will be impossible to eliminate TB from the U.S. in this century. These findings support the need to maintain current activities to find and treat people with TB disease, but new strategies are needed to accelerate progress toward elimination. Such strategies include proactively identifying and treating people with latent TB infection and broadening responsibility for latent TB infection testing and treatment to private healthcare providers and community health centers serving populations at increased risk for exposure to TB.

Tuberculosis Among Foreign-Born Persons Diagnosed ≥10 Years After Arrival in the United States, 2010–2015

National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
404-639-8895
NCHHSTPMediaTeam@cdc.gov

The majority of U.S. tuberculosis (TB) cases are due to reactivation of latent TB infection (LTBI), often acquired years before the infection progresses to active TB disease. While people with LTBI do not feel sick, do not have symptoms, and cannot spread TB bacteria to others, five percent to 10 percent of people will eventually develop TB disease, making screening and treating LTBI critical components of the effort to eliminate TB. To better understand the epidemiology of TB, CDC researchers examined factors related to the disease among a population at high risk of exposure to TB: individuals born outside of the U.S. Many parts of the world lack comparable TB control systems to the U.S.; thus people who have traveled to, lived in, or were born in those countries are at higher risk of being exposed to TB. For a clearer picture of how this group of patients differs based on time of diagnosis since arrival to the U.S., CDC analyzed data for all reported TB cases in the U.S. since 1993. The analysis found the proportion of persons developing active TB who arrived in the U.S. 10 or more years prior to diagnosis has increased over the proportion who arrived less than 10 years prior to diagnosis. The analysis also found that those who developed TB and arrived 10 or more years ago were more likely to be residents of long-term care facilities or to have immunocompromising conditions (other than HIV). These data support existing testing and treatment guidelines for all individuals at increased risk for LTBI.

Establishing a Timeline to Discontinue Routine Testing of Asymptomatic Pregnant Women for Zika Virus Infection

CDC Media Relations
404-639-3286

Establishing a timeline for ending screening of pregnant women without symptoms for Zika virus infection allows the American Samoa Department of Health to allocate resources appropriately toward early interventions for children and families affected by Zika virus. Also, as cases of Zika decline, there is an increased likelihood of false-positive test results. These results can unnecessarily burden the healthcare system and have negative psychosocial repercussions for women and their infants. Enhanced surveillance data in American Samoa indicate that local mosquito-borne transmission of Zika virus has been interrupted. From the start of enhanced Zika virus surveillance on August 31, 2016, through three mosquito incubation periods ending October 15, 2016, no rRT-PCR-positive cases were identified. The last rRT-PCR positive case had onset of symptoms on June 19, 2016. CDC supported the American Samoa Department of Health in calculating an October 15, 2016 end date for active mosquito-borne transmission of Zika virus and to propose a timeline for discontinuation of routine screening of asymptomatic pregnant women in American Samoa (conception after December 10, 2016, with permissive testing for asymptomatic women who conceive through April 15, 2017).

Self-Reported Work-Related Injury or Illness — Washington, 2011–2014

CDC Media Relations
404-639-3286

The Behavioral Risk Factor Surveillance System (BFRSS) can provide valuable information for tracking, monitoring and prevention of work-related illness and injuries. The Behavioral Risk Factor Surveillance System (BFRSS) is underused when it comes to tracking work-related injuries and illness. A Washington State study shows that the survey can provide more complete data than traditional occupational health information gathering tools. Washington’s Department of Labor & Industries adds occupational injury and illness questions to the state BRFSS survey to better understand who’s at risk. Data from 2011–2014 show that workers from transportation, construction, and agriculture industries had more injuries than others. The study also showed a number of other factors were associated with workplace injuries and illness including gender (male), socioeconomic status, chronic health conditions, and substance abuse. The use of BRFSS can provide valuable information for tracking, monitoring, and prevention of work-related illness and injuries.

Notes from the Field:

• Obstetric Tetanus in an Unvaccinated Woman After a Home Birth Delivery — Kentucky, 2016

Quick Stats:

• Percentage of U.S. Women Aged 50–74 Years Who Had Never Had Mammogram, by Place of Birth and Length of Residence in the United States — National Health Interview Survey, 2013 and 2015

###

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

CDC works 24/7 protecting America’s health, safety, and security. Whether diseases start at home or abroad, are curable or preventable, chronic or acute, stem from human error or deliberate attack, CDC is committed to respond to America’s most pressing health challenges.