Why Is TB on the Rise in the United States?

What caused TB cases to increase the United States?

Cases of TB dropped rapidly in the 1940s and 1950s when the first effective antibiotic treatments for TB were introduced. In 1985, however, the decline ended and the number of active TB cases in the United States began to rise again. Several factors, often interrelated, were behind TB's resurgence.

• The HIV/AIDS epidemic- People with HIV are particularly vulnerable to moving from infection with M. tuberculosis to active TB and are also more likely to develop active TB when they are first infected with TB bacteria.
• People from many nationalities live in the United States- Increased numbers of foreign-born nationals come from places where many cases of TB occur, such as Africa, Asia, and Latin America. TB cases among foreign-born nationals now living in the United States account for more than half of the U.S. total.
• Increased poverty, injection drug use, and homelessness-TB transmission is rampant in crowded shelters and prisons where people weakened by poor nutrition, drug addiction, and alcoholism are exposed to M. tuberculosis.
• Failure of patients to take all prescribed antibiotics against TB-TB patients who do not complete TB drug treatment can stay infectious for longer periods of time and therefore can spread TB to more people. In addition, treatment failures may result in M. tuberculosis strains that are resistant to one or more of the standard medicines given to TB patients, making the disease much more difficult to treat.
• Increased numbers of residents in long-term care facilities such as nursing homes-Many elderly people whose general health has declined develop active TB from TB infection they had much earlier in life. Other elderly people, especially those with weak immune systems, become newly infected with M. tuberculosis and can develop active TB rapidly.