Studies show that tuberculosis rates in the United States rose by more than 9% in 2021 after plunging early in the pandemic.

Various factors are involved

Researchers have presented several theories about changes in TB trends over the last three years, many of which are related to the Covid-19 pandemic.

They said infection control efforts and travel bans could have truly reduced cases of tuberculosis since 2019. The disruption to the US healthcare system probably meant overlooking or delaying the diagnosis, in addition to the potential misdiagnosis of tuberculosis by Covid-19. Duplicate respiratory symptoms.

Minnesota’s recent TB trends reflect national trends, and authorities believe the same factors may be at work.

The number of cases increased from 2.05 per 100,000 in 2020 to 2.35 in 2021, but still below 2.62 in 2019.

Sarah Gordon, the director of the State Department’s TB control program, believes that the same causes pointed out in the CDC study apply to her state.

“The mitigation of Covid-19 and changes in immigration patterns and travel to the United States during a pandemic have really reduced the incidence of tuberculosis,” Gordon wrote in an email. “There is less misdiagnosis or delay in diagnosis of tuberculosis from patients who are not initially screened for tuberculosis or who are less likely to seek medical care during a pandemic.”

Gordon also said the missing case could increase infection and encourage further spread.

Gordon does not expect the 2022 case rate in Minnesota or the United States to exceed the 2019 and subsequent case rates, but said misdiagnosis or delayed diagnosis is still a “concern.”

“With a large global infection pool, the number of cases is expected to grow slowly over the next few years, but it should be remembered that the number of cases in MN varies from more than 200 cases per year. Yes, from the early 2000s to the extreme lows of 2020. “

According to the TB Elimination Alliance, the reduction in tests is part of the result of the workforce diversion by Covid-19.

“Through the Covid-19 pandemic, staff and resources have been diverted from public health infrastructure to Covid-19’s response efforts,” the group’s steering committee wrote in an email.

“For example, 30% of San Francisco’s Population and Health Department staff have been diverted to the Covid-19 response,” they said, and the number of people who lost their health insurance after losing their jobs also limits access to care. He added that there is a possibility.

Latent infections can be part of the increase

Tuberculosis is a bacterial infection that usually occurs in the lungs and can cause coughing, chest pain, and fever.

Tuberculosis is partially functioning by a “latent infection” that is different from active illnesses.

“Latent infections are the dormant or inactive phase of tuberculosis when a person is neither sick nor infectious. Latent infections can progress to active diseases where a person is ill,” Gordon said. Said.

These latent infections may be one of several reasons for the increase seen in certain groups of CDC studies.

CDC data show an overall reduction in tuberculosis diagnosis for people migrating to the United States within a year of immigration, consistent with a decline in pandemic-related travel and immigration. However, over the past year, there has been an increase in cases of non-US-born people who have been in the United States for more than 20 years.

“Even in the United States, we’ve seen delays in diagnosing tuberculosis patients,” Gordon said. “This made people more ill, less treated longer, and thus gave birth to people who were infected longer. This is a pool of people with more potential infections and latent tuberculosis infections. Means that has increased. “

World Tuberculosis Day, worst mortality rate in years

March 24th is World Tuberculosis Day. According to WHO, this year’s tuberculosis mortality rate is the worst in 10 years.

“WHO has reported an increase in tuberculosis deaths for the first time in more than a decade,” Tedros Adhanom Gebreez said Thursday.

At the time of the report, the authors said, “The effects of the Covid-19 pandemic have reversed the year of global progress in reducing the number of people dying from tuberculosis.” Today, according to WHO, there are additional concerns about future expansion.

Financing to combat tuberculosis is “especially important in the Covid-19 pandemic situation, which, coupled with conflicts in Europe, Africa and the Middle East, disrupts services to tuberculosis and puts an even greater burden on affected people. “I’m playing,” Tedros said.

“We are particularly interested in the health of tuberculosis patients in Afghanistan, Ethiopia, Syria, Ukraine and Yemen, where conflicts endanger access to services and their lives themselves,” he said. ..

“Given the heavy burden of drug-resistant tuberculosis in Ukraine, WHO is working closely with partners to support access to tuberculosis care services, including refugees and refugees.”