suzanne j. keller, ma division of disease prevention virginia department of health tuberculosis in...
TRANSCRIPT
Suzanne J. Keller, MADivision of Disease PreventionVirginia Department of Health
Tuberculosis in Virginia
and the United States, 2007
November 2008
Overview of Presentation
• Sketch trends in US and Virginia
• Describe the epidemiology of TB in Virginia
• Compare US and Virginia data on key variables
Key National Highlights in Tuberculosis, 2007
• 13,299 TB cases reported for a case rate of 4.4 per 100,000
• 58% of all TB cases in the US occurred among foreign-born persons
• All racial and ethnic groups except whites have case rates higher than the national average
Reported TB Cases* United States, 1982–2007
10,000
12,000
14,000
16,000
18,000
20,000
22,000
24,000
26,000
28,000
1983 1986 1989 1992 1995 1998 2001 2004 2007
Year
Nu
mb
er o
f C
ases
*Updated as of April 23, 2008.
Reported TB Cases Virginia 1980-2007
309
Key Virginia Highlights in Tuberculosis, 2007
• 309 cases reported in 2007 for a case rate of 4.0 per 100,000
• 74.4% of cases reported among the foreign-born
• For the second year in a row, cases among the US-born declined substantially
TB Case Rates,* United States, 2007
< 3.5 (year 2000 target)
3.6–4.4
> 4.4 (national average)
D.C.
*Cases per 100,000.
TB Case Rates by RegionVirginia, 2007
1.4
9.3
1.5 2.42.6
Total Rate: 4.5
Percent of Reported TB Cases by Age Virginia, 1998-2007
0
10
20
30
40
50
1998 1999 2000 2001 2002 2003 2004 2005 2006 2007
Year
Perc
en
t o
f C
ases
0-14 15-24 25-44 45-64 65+
Reported TB Cases by Age and SexVirginia, 2007
0
10
20
30
40
50
60
70
0-14 15-24 25-44 45-64 65+
MaleFemale
Nu
mb
er o
f C
ases
Age Group
Percent of TB Cases by Race/EthnicityVirginia, 2007
Hispanic31%
White11%
Black25%
Asian/Pacific Islander
33%
TB Cases By RegionVirginia, 2003-2007
0
20
40
60
80
100
120
140
160
180
200
Nu
mb
er o
f C
ases
Northwest Southwest Central Eastern Northern
2003
2004
2005
2006
2007
Percentage of TB Cases Among Foreign-born Persons, United States*
>50%25%–49%<25%
1997 2007
DC DC
*Updated as of April 23, 2008.
Foreign vs. US Born TB Cases Virginia 1998-2007
0
50
100
150
200
250
1998 1999 2000 2001 2002 2003 2004 2005 2006 2007
Year
Nu
mb
er
of
cases
US Born Foreign Born
Trends in TB Cases in Foreign-born Persons, United States, 1987–2007*
0
2,000
4,000
6,000
8,000
10,000
1987 1989 1991 1993 1995 1997 1999 2001 2003 2005 2007010203040506070
No. of Cases Percentage of Total Cases
No. of Cases Percentage
*Updated as of April 23, 2008.
Foreign-born TB Cases Top Five Countries of Birth: US and Virginia
• Mexico
• Philippines
• Vietnam
• India
• China
• El Salvador
• Philippines
• India
• Bolivia
• Mexico
US (2007) Virginia (2007)
Estimated HIV Coinfection in Persons Reported with TB, United States,
1993–2006*
0
10
20
30
1993 1995 1997 1999 2001 2003 2005
All Ages Aged 25–44
% C
oin
fect
ion
*Updated as of April 23, 2008.
Note: Minimum estimates based on reported HIV-positive status among all TB cases in the age group.
2006
Number of Reported TB/AIDS CasesVirginia, 2003-2007
21
15
2122
10
0
5
10
15
20
25
2003 2004 2005 2006 2007
Year
Nu
mb
er
of C
ase
s
Primary MDR TBUnited States, 1993–2007*
0
100
200
300
400
500
1993 1995 1997 1999 2001 2003 2005 2007
0
1
2
3
No. of Cases Percentage
*Updated as of April 23, 2008.
Note: Based on initial isolates from persons with no prior history of TB. MDR TB defined as resistance to at least isoniazid and rifampin.
No. of Cases Percentage
MDR Cases & Percent of Cases with Resistance to Any First Line Drugs:
VA, 2003-2007
21
3
55
13.8
5.1
11.212.8
10.7
0
2
4
6
8
10
12
2003 2004 2005 2006 2007
Num
ber
0
2
4
6
8
10
12
14
16
Per
cent
Thanks
National Data Slides from CDC