Last Update: March 31, 2004

Division of Tuberculosis ControlVirginia Department of Health

Epidemiology of Tuberculosis in Virginia, 2002

Last Update: March 31, 2004

Tuberculosis (TB):A Disease of Public Health Significance

Potentially fatal disease transmitted by prolonged contact 19 deaths in 2002

Long, multidrug treatment regimens increase risk of nonadherence

Serious impact of improper/inadequate treatment on community

Disproportionate impact on disenfranchised

Last Update: March 31, 2004

TB Control Challenges in Virginia

Rising morbidity in Northern Virginia

Increasing proportion of TB patients born outside the United States 38 different countries of origin 15 different primary languages (other than

English)

High incidence of drug-resistant cases

Last Update: March 31, 2004

Number of Reported TB Cases inVirginia, 1980-2002

315 cases in 2002

Last Update: March 31, 2004

TB Case Rates in Virginia, 1994-2002

Year # of Cases VA Rate US Rate

1994 372 5.8 9.4

1995 350 5.5 8.7

1996 349 5.3 8.0

1997 349 5.3 7.4

1998 339 5.2 6.8

1999 334 4.9 6.4

2000 292 4.1 5.8

2001 306 4.3 5.6

2002 315 4.5 5.2

Last Update: March 31, 2004

Percent of Reported TB Cases byVirginia Region, 1992 and 2002

Northern27%

Northwest9%Central

20%

Southwest12%

Eastern32%

Eastern23%

Northern51%

Southwest7%

Central11%

Northwest 8%

1992 2002

Last Update: March 31, 2004

Number of Reported TB Cases By Virginia Region, 1998-2002

0

20

40

60

80

100

120

140

160

180

Nu

mb

er

of C

ase

s

Northwest Southwest Central Eastern Northern

Virginia Region

1998

1999

2000

2001

2002

Last Update: March 31, 2004

Number of Reported TB Cases byAge and Sex: Virginia, 2002

0

10

20

30

40

50

60

70

Num

ber o

f Cas

es

0-14 15-24 25-44 45-64 65+

Age Range

Male

Female

Last Update: March 31, 2004

Percent of Reported TB Cases by Age: Virginia, 1995-2002

0

5

10

15

20

25

30

35

40

45

1995 1996 1997 1998 1999 2000 2001 2002

Year

Pe

rce

nt o

f Ca

ses

0-14 15-24 25-44 45-64 65+

Last Update: March 31, 2004

Number of Reported Foreign- vs. US-Born TB Cases: Virginia, 1993-2002

0

50

100

150

200

250

300

350

1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

Year

Nu

mb

er

of c

ase

s

US Born Foreign Born

Last Update: March 31, 2004

Percent of Reported TB Cases with Resistance to Any First Line Drugs*

16.3

12.214.1

10.912.8

0

2

4

6

8

10

12

14

16

18

1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

Year

Pe

rce

nt o

f Ca

ses

Virginia, 1994-2002

Last Update: March 31, 2004

Number of Reported TB/AIDS Cases in Virginia, 1995-2002

0

5

10

15

20

25

30

35

1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

Year

Nu

mb

er

of C

ase

s

Last Update: March 31, 2004

Directly Observed Therapy (DOT)

DOT is the standard of treatment

Patients are observed taking their medications

In 2002, 75% of TB cases were on DOT

Last Update: March 31, 2004

Percent of Reported TB Cases onDOT vs. Self-Administered: VA, 1995-2002

0

10

20

30

40

50

60

70

80

1995 1996 1997 1998 1999 2000 2001 2002

Year

Pe

rce

nt o

f Ca

ses

Self-administered Administered by DOT