Archives of the Mayor's Press Office

MAYOR GIULIANI ANNOUNCES THAT TUBERCULOSIS RATE IS
LOWEST EVER RECORDED IN NEW YORK CITY HISTORY

Mayor Rudolph W. Giuliani -- joined by Health Commissioner Neal L. Cohen, M.D. -- today announced that the tuberculosis (TB) rate is the lowest ever recorded in New York City and that the number of new TB cases in New York City in 2000 decreased significantly for the eighth consecutive year. Overall, cases have declined by 65% since the peak of the 1992 TB epidemic in the City. In addition, Mayor Giuliani announced that the Department of Health (DOH) is placing special emphasis on screening and testing immigrants from high risk groups, in response to recent data showing a growing proportion of new TB cases among foreign-born New Yorkers.

"The New York City Health Department maintains one of the best tuberculosis control programs in the world," Mayor Giuliani said. "The Department's strong commitment to proven, effective strategies like Directly Observed Therapy has helped produce the continuing rate of decline in TB cases. Nonetheless, TB continues to be a significant public health problem, and it is imperative we continue to treat the disease, and work to prevent its spread."

Health Commissioner Neal L. Cohen, M.D., said, "In 2000, there were 1,332 new cases of tuberculosis in New York City, a decrease of 8.8% from 1999, and a 65% decrease from 1992, the peak year of the recent epidemic. The case rate for 2000 --16.6 per 100,000 persons -- is the lowest the City has ever recorded. In addition, preliminary data indicate that the number of cases of multidrug-resistant TB, which can develop when full treatment is not completed, and which can be much more difficult to treat, has once again decreased. The number of new multidrug-resistant TB cases in 2000 was 21, a 32.3% decrease from the 1999 total of 31 cases, and a 95% decrease from the 1992 total of 441 cases."

Sonal Munsiff, M.D., Acting Assistant Commissioner for TB Control, said, "As an increasing share of new TB cases is occurring among the foreign--born, the Department of Health is reaching out to communities at high risk for TB with targeted strategies to increase understanding of and encourage testing for TB. The Health Department's goal is to ensure that all New Yorkers with TB receive and complete treatment."

While the number of new TB cases among foreign--born residents of New York City decreased from 1999 to 2000, the number of cases among U.S--born New Yorkers decreased at a faster rate. Therefore, the share of the City's new TB cases increased among the foreign--born: 57.7% of new TB cases in New York City in 2000 were among foreign-born persons, up from 55.6% in 1999. In 1992, only 17.7% of TB cases were reported among foreign--born persons.

The highest number of cases of TB among foreign-born populations in New York City have occurred among persons born in China, the Dominican Republic, Haiti, Ecuador, India and Mexico. The DOH's proactive TB strategies target these high--risk communities by working closely with health care providers to enhance their knowledge about groups that may be of high risk for TB, and to encourage testing for TB. The DOH is also collaborating with community leaders and organizations in immigrant communities at highest risk for TB to implement effective, targeted intervention strategies.

TB rates are also down in both the number and proportion of persons co-infected with TB and HIV. In 2000, 17.8% of TB patients were HIV infected compared to 22% in 1999, and 34% at the height of the recent TB epidemic in 1992.

New York City's use of Directly Observed Therapy (DOT), in which a trained health worker observes and records every dose of medication that a patient takes until the course of treatment is completed, has been instrumental to declining TB rates in the City over the past several years. The World Health Organization has made DOT central to its efforts to control TB globally.

In addition to administering DOT and other TB outreach services, the DOH provides clinical services through ten chest clinics which provide a comprehensive range of TB services Citywide, and conducts extensive TB surveillance and epidemiologic reviews to identify communities at highest risk. The DOH also regularly hosts public officials from nations worldwide to show them how to implement effective TB control strategies.

Since 1992 -- the peak year of the recent Tuberculosis epidemic -- the number of new TB cases in New York City has declined 65% and the number of new Multidrug--resistant TB cases has declined 95%. The following is a breakdown of new TB and Multidrug-resistant TB cases as reported to the New York City Health Department between 1992 and 2000.