1.       According to the World Health Organization (WHO), tuberculosis (TB) kills approximately 2 million people each year. The global epidemic is growing and becoming more dangerous. Currently, there are 2 billion people worldwide (one third of the world’s population) infected with the TB bacillus (having latent TB infection, or LTBI). Five to ten percent of the people who are infected with TB (but who are not infected with HIV) become sick or infectious at some time during their life.  The epidemics of HIV/AIDS and multi-drug resistant tuberculosis (MDR-TB) have also impacted on the spread of TB.  Tuberculosis is the single most common opportunistic infection for people with HIV.  Thus, TB is a major cause of death in people who are HIV positive. It accounts for about 13% of AIDS deaths worldwide. Consequently, WHO targets, ratified by the World Health Assembly in 1991, are to detect 70% of new infectious TB cases and to cure 85% of those detected by 2005. Eighteen countries had already achieved these targets in 2002. Globally, 37% of the estimated number of TB patients received treatment under the Direct Observed Therapy (DOTS) strategy in 2002, two and a half times the fraction reported in 1995. The average success rate for treatment under the DOTS strategy was 82%.¹  

2.       During 2003, a total of 14,871 TB cases (5.1 cases per 100,000 population) were reported in the United States , representing a 1.4% decline in cases and a 1.9% decline in the rate from 2002. This decline is the smallest since 1992 when TB incidence peaked after a 7-year resurgence. In addition, the rate remains higher than the national interim goal of 3.5 cases per 100,000 population that was set for 2000.   In California, Los Angeles County (LAC) still has the highest number of TB cases in California for the year 2003.  LAC accounted for 29.4% of the TB cases in California (3,230  cases provisional data) and 6.4% of the 14,871 TB cases (provisional data) reported in the United States in 2003.²  

3.       During 2003, there were 949 TB cases confirmed in LAC.  This represents a 7.4% decrease in TB cases from 2002 (1,025 cases) and an overall 56.8% decrease since the peak of 1992 (2,198 cases).  Similar to the whole nation, this was the eleventh year of decline since 1992.  The average annual percent decline from 1992 to 2003 was 7.4%. ³  

4.       In Los Angeles County during 2003, there were a greater number of TB cases diagnosed in males (566 cases, 59.6%) than in females (383 cases, 40.4%).  

5.       The largest number of TB cases was found among the 15-34 age group with 246 cases (25.9%), followed by the 65 and over year age group with 238 cases (25.1%), the 35-44 year old age group with 158 cases (16.7%), the 45-54 year old age group with 150 cases (15.8%), and the 55-64 year old age group with 119 cases (12.5%).  Compared to 2002, there was an increase in the proportion of TB cases in 2003 for the following age groups: 0-4, 15-34, 55-64, and 65 and older respectively.  

6.       The racial/ethnic breakdown of TB cases reported in 2003 was as follows: 434 (45.7%) Hispanic, 346 (36.5%) Asian/ Pacific Islander, 90 (9.5%) African American, 78 (8.2%) non-Hispanic White, and 1 (0.1%) Native American.  

7.       During 2003, 78.9% (749) of the 949 total TB cases occurred in the foreign-born population.  Of the 749 foreign-born cases, 257 (34.3%) were from Mexico , 145 (19.4%) from the Philippines , 53 (7.1%), from China , 44 (5.9%) from South Korea , 41 (5.5%) from Vietnam , 33 (4.4%), from Guatemala , 29 (3.9%) from El Salvador , and 18 (2.4%) from Honduras .  Among the 749 foreign-born TB cases, 724 (96.7%) had date of arrival in the U.S. identified.  Of the 724, 211 (29.1%) were recent immigrants, having immigrated to the U.S. fewer than three years ago.  

8.       In 2003, 75 (7.9%) TB cases were HIV co-infected; of these 75, 63 (84.0%) were male.  Among all HIV-infected TB cases, 49 (65.3%) were Hispanic, 12 (16.0%) were African American, and 9 (12.0%) were non-Hispanic White and 5 (6.7%) were Asian/Pacific Islander, Fifty-five (73.3%) of the HIV co-infected cases were in the 25-44 year old age group, and 15 (20.0%) in the 45-64 year old age group.   

9.       Seventy-four (7.8%) of the 949 TB cases were reported as homeless in 2003; 57 (77.0%) of these were male.  Among all homeless TB cases, 36 (48.7%) were Hispanic, 22 (29.7%) were African American, 12 (16.2 %) were non-Hispanic White, 3 (4.1%) were Asian/ Pacific Islander and 1 (1.4%) Other. Twenty-six (35.1%) of the homeless TB cases were in 35-44 year old age groups, 23 (31.1%) were in 45-54 year old age group, 11 (14.9%) were in the 15-34 year old age group, 9 (12.2%) were in the 55-64 year old age group, and 5 (6.8%) were in the 65 and over age group.  

10.    Seven hundred fifty eight cases (79.9%) were pulmonary TB, and the remaining 191 cases (20.1%) had extra-pulmonary TB only. 

            1.  Tuberculosis Fact Sheet No. 104, March 2004, Website, http://www.who.int/mediacentre/factsheets/fs104/en/

            2.  MMWR Weekly, 53(10): 214; March 19, 2004 .  CDC Website, http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5310a2.htm

            3.  Epidemiology Services, TB Control Program, Department of Health Services, Los Angeles County .  Tuberculosis Epidemiology Assessment (TEAM) Report 2003; Volume 2004.