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Drug-Resistant TB Continues in California

Tuberculosis Not Just in Cities

Epidemiologists have long observed that tuberculosis tends to concentrate in urban centers. But researchers were alarmed by findings showing reports of multidrug-resistant tuberculosis in more than half of California's health jurisdictions, including several rural counties.

"Multidrug-resistant TB has spread across the state," Granich says.

Researchers call for stronger efforts aimed at identifying and treating tuberculosis overseas, noting that the majority of infected persons in the California study were from foreign countries. They also note that one-third of multidrug-resistant tuberculosis patients in California did not complete their treatment and that officials must step up efforts to improve complete treatment of the disease.

Catherine D. DeAngelis, MD, editor of JAMA, told reporters that relatively low domestic tuberculosis rates have convinced much of the public that the disease is no longer a threat in the U.S. But worldwide tuberculosis infection rates are 33 times higher than those for HIV.

"Don't get too comfortable. It is a global problem," she says.