I think this issue is a matter of semantics. According to the usually accepted scientific definition of "epidemic" which you stated, the US epidemic was over when TB cases peaked in 1992. There is currently no epidemic of TB in the US.

A casual or lay use of the term "epidemic" might include "a lot of cases of something" which sounds like basically the way you're using it, although I think that's a very confusing way to use it. Yes, there are still a not-insignificant number of Americans developing TB every year, but it's fewer Americans than ever. We still have a long way to go to reach the stated goal of one case per million population. We'd have to get down to three hundred cases a year to realize that dream. However, just because TB exists in the numbers we see today or because there is a campaign to eliminate it does not mean that there is an epidemic of TB in this country.

So I would agree that TB is still a problem in this country, but I would disagree that there is a TB epidemic.

However, you just mentioned "worldwide" in the latest response. The article you linked to and our discussion so far has been about TB in the US. The global situation, in the Third World in particular, is very different from the US situation. If you want to talk about the global TB situation, then I would agree that there is a global epidemic of TB.

Yeah, you are definitely right. I was wrong to refer to it as a current epidemic here in the U.S. I wrongly thought that drug-resistant TB was on the rise in certain communities, but even that is under good control. Oh well, I learn something new every day.

I must admit that my vision was broader than just the U.S. in my general discussion of TB, but yes, strictly speaking of U.S. efforts, we have seen success. I believe I agreed with you on that in the previous post. What I disagreed with you on was that you didn't refer to the epidemic in the 80's and early 90's as an epidemic. But no biggie!

Thanks for correcting me. Always good to learn new stuff.

I just received my Medscape on-line subscription synopsis today and the main article was:

Hot Topic: Epidemiology of Tuberculosis among Foreign-Born Residents of the United States (posted 10/10/08) Tamar F. Barlam, M.D.; Dennis L. Kasper, M.D.

Here is a link to the article, I do not know if it will work if you are not a member (It is my account, so please do not abuse the opportunity, if it works), so here is also the first paragraph:

Link

Although the overall incidence of tuberculosis (TB) is declining in the United States, the number of cases among foreign-born persons has increased. In 2006, foreign-born persons accounted for 57% of all TB cases in this country. TB among foreign-born residents is usually due to reactivation of infection acquired before arrival in the United States. Population-based data are needed to guide strategies for identifying, treating, and preventing TB in foreign-born persons.

Pete

Medscape does require registration, but it's free.

Actually, I read the actual article and I'm surprised that this was published in a prestigious medical journal because this info is nothing new. Everyone uses the same TB registry so to understand the point I made earlier in this thread, just look at these numbers from the CDC here . Scroll down one page to Table 5. This article only covers 2001-2006 but this table I'm referring to goes back to 1993.

Even if you're not really math-savvy, I think the pattern is apparent. Just look at the number of cases among US and foreign-born Americans since 1993. The number of cases among the foreign-born is quite stable over time, but the number of cases among the US-born Americans has fallen significantly since 1993. Then look at what happens to the percentages for the foreign-born--they go up significantly even though the actual number of cases is basically the same because the overall number of cases each year has shrunken.