While the number of cases of tuberculosis among North Carolina residents has declined over the last two decades, cases among foreign-born residents are increasing, the Raleigh News & Observer reports. Foreign-born residents account for more than 40% of the state's cases, and the number is increasing as the foreign population grows, according to the News & Observer. In 2000, 26% of the state's cases were among foreign-born residents compared with less than 3% in 1983. Meanwhile, the number of cases among non-immigrants in the state is declining, according to Jeff Engel, a North Carolina epidemiologist.

Nationwide, 57% of TB cases in 2006 were among foreign-born residents, and between 1993 and 2006, the number of cases among foreign-born residents increased by 5%. The number of cases among the rest of the U.S. population declined by 66% from 1993 to 2006, according to the News & Observer. "If we continue on this trend, it's going to be a big problem," Maureen O'Rourke, TB program manager at the state Division of Public Health, said.

A recent CDC study found that about 30% of immigrants in the U.S. -- including students, migrant workers, visitors and undocumented immigrants -- have never been tested for the disease, which is treatable with antibiotics. Public health officials contend that increased screening and treatment for the disease could stop the spread. However, the state has limited resources available to treat thousands of new patients, and under federal law those without health insurance are eligible for no-cost care. Engel said he would like to begin an awareness campaign encouraging immigrants to be screened for the disease but it would require more federal funding. "I think it's a major concern," Engel said, adding, "A national concern" (Collins, Raleigh News & Observer, 8/6).