MMWR: Progressing Toward Tuberculosis Elimination in Low-Incidence Areas of the United States: Recommendations of the Advisory Council for the Elimination of Tuberculosis

This report provides recommendations from the Advisory Council for the Elimination of TB (ACET) concerning TB elimination in low-incidence areas. In 1999, ACET called for a renewed commitment to its strategic plan, originally published in 1989 with a year 2000 objective of 3.5 cases per 100,000 population. Also in 2000, the Institute of Medicine proposed a comprehensive action plan for TB elimination in the United States. In 2000, 22 states reported incidence rates of =3.5/100,000, which was the objective set by ACET in its 1989 strategic plan. Also, US counties reporting no TB cases have increased, and health departments in low-incidence states and low incidence regions within states need distinctive strategies for maintaining skills and resources for finding the few TB cases, containing outbreaks, and ending TB transmission. The essential components of TB prevention and control programs must be retained at local, state, and national levels. In low-incidence areas, adequate public health infrastructure and creative integration of resources are important. Operational research is needed for determining the most efficient control measures. With continued success in eliminating TB, low incidence will be attained in all states, and the nation will profit from the lessons learned in low-incidence states.