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New TB Cases In City Up Slightly Last Year The number of new tuberculosis cases in the City rose five percent, from 1,084 in 2002 to 1,140 in 2003 according to preliminary data released last week by the New York City Department of Health and Mental Hygiene (DOHMH). While City TB cases remain near historic lows, 2003 marked the first rise in new TB cases in more than a decade. The rise in foreign-born TB cases in New York City is related to the ongoing, global TB epidemic. New York City Health and Mental Hygiene Com-missioner Thomas R. Frieden, MD, MPH was joined by Assistant Commissioner for Tuberculosis Control Dr. Sonal Munsiff, Dr. Carlos Navarro of Casa Mexico, and Dr. George Alonzo of Elmhurst Medical Center at a press conference held at DOHMH in observance of the annual World TB Day (March 24). The new data also show that while there were fewer cases of multi-drug-resistant tuberculosis over the same period, the rise in TB cases was among the non-US born. Cases of homeless persons with TB also increased. Commissioner Frieden said, "New York City continues to employ pioneering techniques, such as Directly-Observed Therapy, to stay at the forefront of TB prevention and control. However, globally, tuberculosis remains a leading killer and case rates in New York City remain almost three times that of the national rate. The increase in the number of cases among foreign-born persons demonstrates that the fight against TB must be waged on two fronts - locally and globally. New Yorkers at highest risk - particularly those in the City’s immigrant communities - should get screened and treated for TB. It is a preventable and curable disease, and we provide TB services for free and regardless of immigration status." Cases in US-born individuals decreased in comparison to 2002. However, there was an increase in cases among the homeless and unstably housed from 49 cases in 2002 to 86 cases in 2003. (In 1991, at the height of the TB epidemic in the early 1990’s, there were 748 cases). Part of the overall TB increase is also due to the change in case-counting methods adopted in 2002. A growing share of the City’s cases is being re-ported among foreign-born persons: in 2003, 67% of new TB cases in New York City were foreign-born, compared to 18% in 1992. The number of foreign-born TB cases also increased from 700 in 2002 to 771 in 2003. The largest number of TB cases in foreign-born individuals has been among persons born in China (including the People’s Republic of China, Taiwan and Hong Kong), Ecuador, the Dominican Republic, Haiti, India and Mexico. In 2003, approximately 31,000 individuals were evaluated for latent TB infection in DOHMH chest centers. About 6,700 high-risk individuals were found to have latent TB and were started on treatment to prevent active TB disease. Additionally, DOHMH evaluated more than 4,100 contacts of infectious TB cases. About 40 percent of these indi- Continued on page 50 viduals were found to be harboring latent TB infection and most were also treated for the latent infection. In addition to administering DOT in patients’ homes and other sites throughout the City and in 10 chest centers, DOHMH conducts extensive TB surveillance and epidemiological reviews to identify communities at risk and provide education and treatment services for them. For more information, visit http://www.nyc.gov/html/doh/html/tb/tb.html
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