Experts at the Centre for Disease Control and Prevention (CDC), Atlanta's Division of Tuberculosis Elimination, feel that it is time the US changed its guidelines and made TB tests mandatory for all foreign-born nationals, irrespective of how long they have been residing there.
Tuberculosis can only be eradicated if all foreign-born residents from high-risk countries are tested and, if necessary, treated for latent TB infection, they say.
They recommend that people who have lived in the United States for five years or less be targeted for tuberculin skin testing and treatment.
'Twenty-five percent of all reported TB cases in the United States are among foreign-born persons who have lived in the U.S. for more than five years,' Kevin Cain, of the Division of Tuberculosis Elimination at the U.S. Centers for Disease Control and Prevention in Atlanta, said in a prepared statement.
'There is no policy to test foreign-born persons for the latent TB infection before entering the U.S., or to test them after they have lived here for more than five years. As such, present guidelines do not currently address the burden of latent TB infection in the foreign-born subgroup.'
'For example, in 2004, a total of 14,517 cases of TB were reported,' Cain said in the statement. 'Of these, 3,444, or 24 percent, were foreign-born persons who had entered the United States more than five years previously.'
'Until we address the burden of latent TB infection in the foreign-born group, achieving TB elimination will not be possible,' Cain said.
It was found that U.S. immigrant residents from the following countries had the largest number of TB cases in 2004: Mexico, Philippines, Vietnam, India, China, Haiti, South Korea, and Guatemala, Ethiopia and Peru.
The above said recommendations were put forth by an eight-member team, headed by Kevin P Cain, which collected data on all TB cases listed in the US National TB Surveillance database. This was done to ascertainwhy the number of annual cases of TB reported in US-born residents declined by 93% from 1993 to 2004, while those among foreign-born cases increased by 5%.