Minnesota Department of Health Tuberculosis Prevention and Control Program

(651) 201-5414

Tuberculosis surveillance data for Minnesota are available on the Web at: www.health.state.mn.us/tb

* Cases per 100,000 population. Rates were calculated using state population estimates from the U.S. Census Bureau.

Year No. Cases Rate*2010 135 2.52011 137 2.62012 162 3.02013 151 2.82014 147 2.7

Year of Diagnosis

Perc

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*Represents only deaths due to TB disease or TB drug-induced toxicity

Year No. Cases No. Deaths* (%)2010 135 3 (2%)2011 137 9 (7%)2012 162 4 (2%)2013 151 2 (1%)2014 147 3 (2%)

* Rate per 100,000 population. Rates were calculated using population estimates from U.S. Census Bureau data.

† Anoka, Carver, Dakota, Scott, and Washington counties

Location of Residence 2010No. (rate)*

2011No. (rate)*

2012No. (rate)*

2013No. (rate)*

2014No. (rate)*

Hennepin County 67 (5.8) 59 (5.0) 71 (6.1) 51 (4.3) 51 (4.3)

Ramsey County 34 (6.7) 31 (6.0) 39 (7.6) 39 (7.5) 26 (4.9)

Suburban Twin Cities Metro†

16 (1.3) 12 (0.7) 27 (2.2) 20 (1.6) 24 (2.0)

Olmsted County 6 (4.2) 9 (6.2) 3 (2.1) 10 (6.8) 16 (10.7)

Other counties 12 (0.5) 26 (1.1) 22 (1.0) 31 (1.3) 30 (1.3)

Total 135 (2.5) 137 (2.6) 162 (3.0) 151 (2.8) 147 (2.7)

Location of Residence 2010No. (rate)*

2011No. (rate)*

2012No. (rate)*

2013No. (rate)*

2014No. (rate)*

Hennepin County 67 (50) 59 (43) 71 (44) 51 (34) 51 (35)

Ramsey County 34 (25) 31 (22) 39 (24) 39 (26) 26 (18)

Suburban Twin Cities Metro†

16 (12) 12 ( 9) 27 (17) 20 (13) 24 (16)

Olmsted County 6 ( 4) 9 ( 7) 3 ( 2) 10 ( 7) 16 (11)

Other counties 12 ( 9) 26 (19) 22 (13) 31 (21) 30 (20)

Total 135 (100) 137 (100) 162 (100) 151 (100) 147 (100)

* Rate per 100,000 population. Rates were calculated using population estimates from U.S. Census Bureau data.

† Anoka, Carver, Dakota, Scott, and Washington counties

Hennepin: 51Ramsey: 26

Suburban metro: 24

Greater MN: 46

Total: 147

Hennepin: 299Ramsey: 169

Suburban metro: 99Greater MN: 165

Total: 732

Place of Birth

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N = 732

* Race categories do not include persons of Hispanic/Latino origin.† Rates were calculated using population estimates from the U.S. Census Bureau.

Case

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** The 2014 patient with multiple races is not represented in this graph.

*Race categories do not include persons of Hispanic/Latino origin.

†Includes U.S.-born children of foreign-born parents

Race / Ethnicity* Foreign-Born CasesNo. (%)

U.S.-Born Cases†No. (%)

White 15 (2) 59 (42)

Black 308 (52) 35 (25)

Asian 211 (36) 14 (10)

Native American / Alaska Native 0 17 (12)

Multi-racial 0 1 (<1)

Hispanic/Latino 59 (10) 13 (9)

Total 593 (100) 139 (100)

* Risk categories are not mutually exclusive † Alcohol abuse and/or illicit drug use

Risk Category* 2010 (N=135)No. (%)

2011 (N=137)No. (%)

2012 (N=162)No. (%)

2013 (N=151)No. (%)

2014 (N=147)No. (%)

Cumulative (N=732)No. (%)

Foreign-born 110 (81) 116 (85) 136 (84) 123 (81) 108 (73) 593 (81)

Substance abuse† 7 (5) 7 (5) 7 (4) 9 (6) 7 (5) 37 (5)

Homeless 3 (2) 2 (1) 2 (1) 4 (3) 7 (5) 18 (2)

HIV-infected 6 (4) 3 (2) 6 (4) 4 (3) 4 (3) 23 (3)

Other medical condition**

23 (17) 27 (20) 20 (12) 35 (23) 37 (25) 142 (19)

Incarcerated 4 (3) 2 (1) 0 (0) 0 (0) 1 (1) 7 (1)

Long-term care resident

3 (2) 2 (1) 1 (1) 2 (1) 0 (0) 8 (1)

** Conditions or therapies that increase risk for progression from latent TB infection to active TB disease, not including HIV/AIDS

* Risk categories are not mutually exclusive† Alcohol abuse and/or illicit drug use

** Conditions or therapies that increase risk for progression from latent TB infection to active TB disease, not including HIV/AIDS

N=732

**Patients could have > 1 medical condition

*Conditions or therapies that increase risk for progression from latent TB infection to active TB disease, not including HIV/AIDS

***Includes TNF α antagonist therapy and post-organ transplantation

Medical conditions**

Cases (N=732)No. (%)

Diabetes 81 (11)

End stage renal disease 19 (3)

Weight loss/undernutrition/malabsorption 6 (1)

Other: silicosis, hematologic disease 3 (<1)

Other immunosuppressive condition or immunosuppressive therapy*** 56 (8)

† Alcohol abuse and/or illicit drug use** Conditions or therapies risk for progression to active TB disease, not HIV

* Risk categories are not mutually exclusive

HIV Status

Foreign-BornCases

No. (%)

U.S.-BornCases

No. (%)Total

No. (%)

Negative 546 (92) 126 (91) 672 (92)

Positive 21 (4) 2 (1) 23 (3)

Refused 4 (1) 2 (1) 6 (1)

Not Offered 22 (4) 9 (6) 31 (4)

Total 593 (100) 139 (100) 732 (100)

Perc

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No. of TB-HIV cases in MN:2005 – 122006 – 82007 – 122008 – 112009 – 72010 – 62011 – 32012 – 62013 – 42014 – 4

No. of

elig

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TB

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* Alive at diagnosis

*Includes: daycare, ESL/ELL, and other schools

School/Setting No. (%)

Preschool 2 (<1)

Elementary 36 (5)

Secondary 31 (4)

Post-secondary 51 (7)

Other* 52 (7)

None 560 (77)

Total 732 (100)

Year

Num

ber

of

Case

s

* “Other” includes: Eastern Europe, North Africa/Middle East, and Western Europe

Region of Birth

Num

ber

of

Case

s

* “Other” includes: Eastern Europe, North Africa/Middle East, and Western Europe

N = 593

N = 593

N = 71

* Per results of pre-immigration screening performed overseas

N = 593

% o

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case

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123136116129 110155175 203

Technical instructions for overseas exams revised

N = 108

N = 732

* Includes cases with or without concurrent pulmonary disease

** Patients may have multiple extrapulmonary sites of disease

Site of disease**

Cases(N=356)No. (%)

Lymphatic 192 (54)

Musculoskeletal 51 (14)

Pleural 40 (11)

Peritoneal 22 (6)

Genitourinary 14 (4)

Brain 14 (4)

Meningeal 11 (3)

Other 26 (7)

* Includes TB cases with or without concurrent pulmonary disease

N = 460

* From initial chest x-ray or chest CT scan

*53% of pulmonary cases without sputum smear results were under 15 years of age

N = 460

N = 732

N = 732

*Based on the public health surveillance definition for TB

[CDC. (2009, June) CDC Tuberculosis Surveillance Data Training: Report of Verified Case of Tuberculosis (RVCT) Instruction Manual. Atlanta, GA: U.S. Department of Health and Human Services, CDC. (Appendix A - Tuberculosis Case Definition for Public Health Surveillance)]

* Culture-confirmed cases with drug susceptibility results available

† Resistance to at least one first-line anti-TB drug [i.e., isoniazid (INH), rifampin, pyrazinamide (PZA), or ethambutol]

** INH-resistant cases may also be resistant to other drugs

‡ Multi-drug resistant TB, defined as resistance to at least INH and rifampin

Year

Cases With Susceptibility

Results*

Any DrugResistance†

No. (%)

INH-Resistant**

No. (%)MDR-TB‡No. (%)

2010 109 13 (12) 5 (5) 0 (0)

2011 101 22 (22) 12 (12) 3 (3)

2012 124 23 (19) 12 (10) 1 (1)

2013 113 24 (21) 13 (21) 0 (0)

2014 105 25 (24) 19 (18) 1 (1)

Total 552 107 (19) 61 (11) 5 (1)

Place of birth

Cases With Susceptibility

Results*

Any DrugResistance†

No. (%)

INH-Resistant**

No. (%)MDR-TB‡No. (%)

Foreign-Born Cases 456 94 (21) 53 (12) 4 (1)

U.S.-Born Cases 96 13 (14) 8 (8) 1 (1)

Total 552 107 (19) 61 (11) 5 (1)

* Culture-confirmed cases with drug susceptibility results available

† Resistance to at least one first-line anti-TB drug [i.e., isoniazid (INH), rifampin, pyrazinamide (PZA), or ethambutol]

** INH-resistant cases may also be resistant to other drugs

‡ Multi-drug resistant TB, defined as resistance to at least INH and rifampin

N = 732

* “Other” includes: other immigration exam – 1.3%, and employment screening (including health care worker screening) – 1.6%

Overseas TB class follow-up

2%

90%

Type of provider

N=722 started on treatment

* DOT = Directly Observed Therapy

90%

* Patients for whom < 12 months of therapy is indicated. This excludes: patients with rifampin resistance, meningeal TB, TB in bone or skeletal system, TB in CNS, children 14 years of age or younger with disseminated TB, patients who died or moved out of US within 366 days of starting treatment. ** Treatment completion data as of 9/14/2015

YearStarted

Treatment*

CompletedWithin 12 mos.**

No. (%)

CompletedOverall**No. (%)

2010 116 105 (91) 115 (99)

2011 101 96 (95) 97 (96)

2012 133 127 (95) 130 (98)

2013 125 116 (93) 123 (98)

Total 475 444 (93) 465 (98)

* Some patients are managed by multiple providers throughout disease course