The epidemiology of tuberculosis (TB) in the United States has changed
dramatically since 1985, with increasing TB incidence through 1992, a
nd a reversal in the upward trend beginning in 1993. The increase in T
B incidence was attributed to the HIV epidemic, increased immigration
from countries with a high prevalence of TB, and decreases in resource
s available to TB control programs. The decline in TB since 1993 has b
een attributed to improvement in TB control in the United States, and
decreased transmission of TB in congregative settings such as hospital
s. The current national decrease trend in TB incidence can be sustaine
d through organized efforts by federal and private agencies and state
and local health departments to ensure that all people with TB are ide
ntified and treated promptly.