Trends in tuberculosis--United States, 2004.

During 2004, a total of 14,511 confirmed tuberculosis (TB) cases (4.9 cases per 100,000 population) were reported in the United States, representing a 3.3% decline in the rate from 2003. Slightly more than half (53.7%) of U.S. cases were in foreign-born persons. This report summarizes data from the national TB surveillance system for 2004 and describes trends since 1993. Findings indicate that although the 2004 TB rate was the lowest recorded in the United States since national reporting began in 1953, the declines in rates for 2003 (2.3%) and 2004 (3.3%) were the smallest since 1993. In addition, TB rates greater than the U.S. average continue to be reported in certain racial/ethnic populations; in 2004, Hispanics, blacks, and Asians had TB rates 7.5, 8.3, and 20.0 times higher than whites, respectively. Essential elements for controlling TB in the United States include sufficient local resources, interventions targeted to populations with the highest TB rates, and continued collaborative efforts with other nations to reduce TB globally.