While most of the country saw increased cases of tuberculosis in 2023, Georgia experienced a slight decline, according to a new surveillance report from the Georgia Department of Public Health.
Considered the world’s deadliest infectious disease, tuberculosis or TB is caused by bacteria spread through the air, typically when someone coughs or sneezes. The disease usually attacks the lungs. It can also affect other parts of the body such as the kidney, spine, and brain, the Centers for Disease Control and Prevention reports. Someone infected with the TB bacteria doesn’t necessarily become sick, but if not treated properly, the disease can be fatal, the CDC says.
A total of 246 TB cases were reported in Georgia in 2023, a 5.4% decline from 260 cases in 2022. The number of TB cases in Georgia decreased by nearly 54% since 2003, the Department of Public Health reported. Nearly half the reported cases were in metro Atlanta. The number of TB cases per 100,000 people decreased by about 8% between 2022 and 2023.
DPH spokesperson Nancy Nydam attributed the drop in TB cases to more patients receiving preventive care such as screening and testing, and increased education and awareness among health care providers who come in contact with patients with TB and screen for the disease, particularly among high-risk populations.
Preliminary estimates as of Nov. 1 show there have been 201 TB cases in Georgia this year, which might change, Nydam added.
Despite the drop in cases, 16 people died of TB in Georgia last year, DPH reported. Since 2019, five to 16 TB deaths occurred each year.
Dr. Jose Vazquez said he sees TB patients several times a month as chief of infectious diseases at Wellstar MCG Health in Augusta. The patients may discover they have TB during treatment for pneumonia or before receiving chemotherapy or medication to suppress their immune system for various conditions such as lupus, rheumatoid arthritis, Crohn’s disease or psoriasis.
Doctors generally test a patient’s blood for TB during such treatment, said Vazquez, who once contracted the disease from treating patients with it. He and other health care workers receive TB tests once a year along with patients at higher risk of contracting the disease, including those who have HIV, battle drug or alcohol addictions, or experience homelessness, Vazquez said.
From personal experience, he said TB can feel like the flu and last about a month. But most people shouldn’t worry about catching the disease. “We have really good early diagnosis and effective treatment. Nowadays we have very good oral antibiotics that are easy to take.”
Even though cases have declined in Georgia, it was ranked seventh highest in the nation for the number of new TB cases in 2023 and was 19th highest for the TB incidence rate among the 50 states, the DPH report stated. In the U.S., as in past years, four U.S. states represented half all TB cases in the country in 2023, according to the CDC report: California, 22%, Texas, 13%, New York, about 9% and Florida, 6.5%.
In Georgia, nearly half the reported cases, about 46%, were in DeKalb, Fulton and Gwinnett counties, with each reporting more than 25 TB cases. More than half the TB cases in the state, about 57%, were not people born in the U.S., with most from Mexico, India, Guatemala and Vietnam. People who have HIV, experience homelessness, or live in group housing or prison also have a higher risk of exposure, DPH reported.
Georgia’s drop in TB cases contrasts to the rise nationwide, with cases of TB increasing by 15.6% from 8,332 cases in 2022 to 9,633 cases in 2023 and incidence rates by 15%, according to a new report from the Centers for Disease Control and Prevention.
The vast majority of U.S. states saw increases in TB cases and incidence rates for the third year since 2020, surpassing pre-COVID-19 pandemic levels. The most recent figures available show about a 6% decline in TB-related deaths from 2021 to 2022, according to the CDC report.
Until last year, TB cases and incidence rates in Georgia had been rising like in the rest of the nation after dropping during the pandemic. Nydam explained, “It is widely held at state and national levels that many cases of TB that would have been identified during 2020 were it not due to the COVID-19 pandemic. Many diagnoses were likely missed or underdiagnosed due to TB having similar symptoms to those as COVID.”
Dr. Kenneth Castro, co-director of the Emory TB Center, said that during the pandemic, medical resources were repurposed from fighting TB to combating COVID-19. While he recognized the recent drop in TB cases in Georgia, he cautioned against viewing it as a premature victory. “Any decrease in the occurrence of TB is good news. If we over-celebrate, we may think we solved the problem, but we haven’t yet. We must sustain these gains.”
The nation is still far from its goal of eliminating TB, said Castro, a former CDC director of the Division of Tuberculosis Elimination. He urged continued vigilance and investments to fight the disease, noting a previous resurgence of TB between 1985 and 1992 after a 30-year downward trend.
Prior to the COVID-19 pandemic, TB case counts and rates had been steadily declining in the country since 1992, the CDC reported.
Much like with COVID-19, curing TB requires a combination of diagnosis, treatment, and preventive efforts such as identifying and screening anyone who came in contact with a TB patient, Castro said. “When you look at cases of tuberculosis, that’s just the tip of the iceberg. … For every person with tuberculosis, there are at least 10 others who need to be identified, contacted, and screened for TB.”
Concerns about TB have surfaced recently.
After one person tested positive last month, Cobb & Douglas Public Health officials tested about 200 students and staff at Walton High School in Marietta for possible TB exposure. But none received positive results, health officials reported. The health department said those who tested negative are required to get a confirmatory test eight to 10 weeks later, which would be in late December or early January.
Snapshot of TB in Georgia
· Cases dropped by 5.4% between 2022 and 2023 and nearly 54% between 2003 and 2023
· Incidence, number of cases per 100,000 people, decreased by about 8% between 2022 and 2023.
· 201 cases as of Nov. 1 this year
· 16 deaths last year
· 63% were men
· 46%, were Black or African American, 25% Hispanic or Latino; 19% Asian
· The largest proportion of TB cases in Georgia, 33%, were ages 25-44.
· People 65 and older had the highest TB incidence; children 5-14 years old, the lowest incidence. Young children are more likely to have deadlier forms of the disease.
Source: Georgia Department of Public Health and the U.S. Centers for Disease Control and Prevention.
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