TB in the U.S.: A Global Problem

The recent news on the young lawyer from Atlanta* who managed to globe trek around the world with a rare, drug-resistant form of Tuberculosis was an eyeopener for many, including myself. I always thought that in the U.S., TB was one of those “diseases from the past” and a problem only for the developing and underdeveloped world. What I have found out though, through the media and my own exploration, is that it’s still very much possible to contract TB in the U.S. In fact, according to an article I read on Reuters yesterday, there were 14,000 cases of the disease reported in the U.S. last year.

I guess it’s important to recognize though, that in comparison to other regions of the world, and most notably Africa, the incidence of TB in the U.S. is still fairly small. A map of TB hot spots around the world really highlights this point. One can clearly see that the real areas of concern lie on the African continent, eastern Europe and parts of Asia, where according to the article I read on Reuters, the cases fall into the millions! Nonetheless, TB is very much present in the US, even if on a much smaller scaler than the rest of the world, one case of TB is one case too many, regardless of where it is. The recent TB scare has gotten people talking about this and has even spurred interest in Congress to increase spending on the domestic control of the disease . The $300 million dollars that is being requested for the next Fiscal Year, according to the senators who are pushing forward the legislation, will go towards developing new diagnostic procedures, drugs and other measures. Some of the money will also go to the Center for Disease Control and state and local health authorities. Clearly, the strategy behind the legislation is to fight the problem at home.

But, to what extent is the problem in the U.S. really a global problem? I mucked around in the data a little bit and found out that while roughly 40% of TB cases in the U.S., originate in the U.S., nearly 60% have origins in other countries of the world. A map of U.S. TB cases by country of origin (excluding the U.S.) for 2005 clearly highlights the geographic reach of the U.S. TB problem.

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So, is this a problem we tackle at home or abroad? We are not a nation of isolation and improvements in aviation technology, cheaper fares and the growing international connections that we continue to make through the wonderful world of e-mail and the Internet, make it easier and more desirable to travel to other points of the globe. Further, we are a land of opportunity and a hopeful destination for many around the world. When I did a quick search on the Internet to find out information on immigrants and TB cases in the U.S., the first hit I got had some staggering statistics. According to the HIVDent Organization, in a CDC news story, the rate of TB in the U.S. in foreign-born persons in 2005 was 9 times that of native borns! So, while certainly the problem of TB in the U.S. is a domestic problem, it is just as much a global problem. And it really underscores the need to continue to attack the problem abroad, not only for the welfare of those in foreign lands but also for the welfare of our own nation.*It should be noted that the man at the heart of the recent TB scare has not yet been found guilty of a crime.