NEW YORK CITY – Monday, March 24, 2008 – The Health Department announced today, World Tuberculosis Day, that TB reached another all-time low in New York City in 2007. A total of 914 cases were reported in 2007 – a 4% decrease from 2006 and a 76% decrease from the high levels seen in the early 1990s. Despite this continuing progress, New York City’s TB rate is still more than double the national rate (11.4 versus 4.4 cases per 100,000 people).
“We continued to make progress this past year, but many challenges remain – especially among New York City’s immigrant communities,” said Dr. Thomas R. Frieden, Health Commissioner of New York City. “Tuberculosis can be prevented and cured and all care and treatment in our centers is free and given without any questions about immigration status.”
Immigrant New Yorkers accounted for 71% of new cases in 2007, with a rate of 24 cases per 100,000 people. The rate among New Yorkers born in the United States was 5.7 per 100,000.
Globally, TB remains a devastating problem, affecting more than 9 million people each year and killing about 1.5 million. In New York City, two out of three TB cases occur among people born in countries with a high rate of TB, such as China, Mexico, and Ecuador – a disparity that is seen throughout the nation. The number of cases among Tibetans in New York City has doubled since 2000 (from 17 to 34). In recent years, TB control services have improved dramatically worldwide, where now more than 30 million people have been diagnosed and treated effectively.
“It’s important for populations at high-risk to know the signs and symptoms of TB and to seek care promptly if they experience these symptoms,” said Dr. Gerry Jacquette, co-chair of the Coalition for a TB-Free NYC. “Those who have been exposed to active TB, here or in their home country, should get tested to see if they need treatment.”
While there has been a decline in cases citywide, TB increased by 11% in Manhattan in 2007, in large part due to an ongoing outbreak in Harlem. To address this problem, which began in 2006, the Health Department is working with medical providers and local hospitals, community boards, and community-based organizations to raise awareness and reduce the spread of disease. The number of TB cases remained stable in Brooklyn and the Bronx in 2007, and the numbers fell in Staten Island (down 18%) and Queens (down 13%). This is the first decline Queens has seen in many years.
Drug-Resistant TB in New York City
Multidrug-resistant tuberculosis (MDR-TB) refers to TB germs resistant to the most potent medications. The number of MDR-TB cases in New York City fell by 57% between 2006 and 2007 (from 15 to 9). New cases of MDR-TB have declined 98% since the early 1990s, due to the expansion of directly observed therapy programs (which ensure all patients take medication by monitoring the patient taking each dose), improved case management and better infection control practices in hospitals.
Extensively drug-resistant tuberculosis (XDR-TB) is resistant to even more drugs than MDR-TB, making it extremely difficult to treat. XDR-TB had been present in New York City since the early 1990s outbreak, but there were no cases in New York City in 2007.
Tuberculosis is a bacterial infection that spreads from person to person through the air. The infection can remain latent for many years before causing active disease, usually in the lungs. When people who are sick with pulmonary TB cough, sneeze, or speak, they expel TB germs into the air. Other people may breathe in the TB germs, and some may become sick.
Brief contact with people who are sick with TB (on a train or bus, for example) is unlikely to cause infection. TB is not spread by shaking hands, sharing food or having sex. The infection is usually spread through close, daily contact.
Most people don’t know they have TB infection until they become sick. People at high risk can stop TB by getting themselves tested and taking treatment to prevent TB disease.
Who Should Get Tested for TB
- People who have symptoms of active TB (coughing,
sweating, fatigue, weight loss, fever)
- People who have spent a long time with someone who
has active TB disease (a family member, friend, or co-worker)
- People who have come recently from a country with a
high rate of TB
- People who have HIV infection, lowered immunity, or
certain medical conditions such as diabetes or chronic kidney failure
- People who have worked or lived in a homeless shelter, prison or other group setting
Free Testing and Treatment
The Health Department has nine Chest Centers located throughout the city, each offering state-of-the-art TB testing and treatment at no charge. Clinics are open at convenient hours, and some are open evenings and on Saturdays. Services are provided regardless of immigration status, and translation services are available in more than 170 languages. A complete list of Chest Center locations is available online at nyc.gov/health or by calling 311.