Minnesota Department of Health Tuberculosis Prevention and Control Program

(651) 201-5414Tuberculosis surveillance data for Minnesota are available on the Web at:

www.health.state.mn.us/tb

Year No. Cases Rate*

2008 211 4.02009 161 3.12010 135 2.52011 137 2.62012 162 3.0

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

Year of Diagnosis

Perc

enta

ge o

f C

ase

s

Year No. Cases No. Deaths* (%)

2008 211 3 (1%)2009 161 1 (1%)2010 135 3 (2%)2011 137 9 (7%)2012 162 4 (2%)

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

59 (5.0)

31 (6.0)

12 (0.7)

9 (6.2)

26 (1.1)

137

(2.6)

61 (5.3)

41 (8.1)

26 (2.2)

8 (5.6)

25 (1.1)

161

(3.1)

Hennepin County

Ramsey County

Suburban Twin Cities Metro†

Olmsted County

Other Counties

Total

67 (5.8)

34 (6.7)

16 (1.3)

6 (4.2)

12 (0.5)

135

(2.5)

2010No.

(rate)* 97 (8.5)

44 (8.8)

23 (2.0)

4 (2.8)

43 (1.9)

211

(4.0)

2008No.

(rate)*Location of Residence

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

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

2009No.

(rate)*

2011No.

(rate)* 71 (6.1)

39 (7.6)

27 (2.2)

3 (2.1)

22 (1.0)

162

(3.0)

2012No.

(rate)*

Hennepin: 71Ramsey: 39

Suburban metro: 27Greater MN: 25

Total: 162

Hennepin: 355Ramsey: 189

Suburban metro: 104 Greater MN:

158

Total: 806

59 (43)

31 (22)

12 ( 9)

9 ( 7)

26 (19)

137

(100)

61 (38)

41 (25)

26 (16)

8 ( 5)

25 (16)

161

(100)

Hennepin County

Ramsey County

Suburban Twin Cities Metro*

Olmsted County

Other Counties

Total

2010No. (%)

67 (50)

34 (25)

16 (12)

6 ( 4)

12 ( 9)

135 (100)

2008No. ( %)

97 (46)

44 (21)

23 (11)

4 ( 2)

43 (20)

211

(100)

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

Location of Residence2009No. ( %)

2011No. (%)

71 (44)

39 (24)

27 (17)

3 ( 2)

22 (13)

162 (100)

2012No. (%)

Place of Birth

Perc

enta

ge o

f C

ase

s

13 ( 0.3)

66 (23.0)

40 (18.0)

3 ( 4.4)

0 ( 0.0)

15 ( 5.8)

137

(2.6)

19 ( 0.4)

80 (32.3)

43 (21.5)

2 ( 2.9)

0 ( 0.0)

17 ( 7.5)

161 (3.1)

White

Black

Asian

American Indian

Multi-racial

Hispanic/Latino

Total

2010No.

(rate)† 11 ( 0.2)

66 (26.7)

41 (20.5)

4 ( 5.8)

0 ( 0.0)

13 ( 5.7)

135 (2.5)

2008No.

(rate)† 16 ( 0.4)

112 (47.9)

48 (25.2)

4 ( 6.9)

0 ( 0.0)

31 (14.2)

211 (4.0)

Race/Ethnicity*

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

† Rate per 100,000 population. Rates were calculated using mid-year population estimates from the U.S. Census Bureau.

2009No.

(rate)†

2011No.

(rate)† 12

( 0.3)

90 (29.4)

42 (17.8)

2 ( 3.1)

0 ( 0.0)

16 ( 6.2)

162

(3.0)

2012No.

(rate)†

55 (34) 56 (35) 14 ( 9) 15 ( 9) 0 ( 0) 20 (13)

160 (100)

16 ( 2)358 (55)200 (31) 0 ( 0) 0 ( 0) 72 (11)

646 (100)

White BlackAsianAmerican IndianMulti-racialHispanic/Latino

Total

Race/Ethnicity*

U.S.-BornCases†

No. (%)

Foreign-BornCases

No. (%)

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

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

155 (73)

21 (10)

11 ( 5)

11 ( 5)

23 (11)

5 ( 2)

3 ( 1)

2008

(N=211)No. (%)

110 (81)

7 ( 5)

3 ( 2)

6 ( 4)

23 (17)

4 ( 3)

3 ( 2)

2010

(N=135)

No. (%)

* Risk categories are not mutually exclusive

Risk Category*

Foreign-born

Substance abuse†

Homeless

HIV-infected

Other medical condition**

Inmate

Long-term care resident

Cumulative (N=806)No. (%)

646 (80)

52 ( 6)

22 ( 3)

33 ( 4)

116 (14)

14 ( 2)

10 ( 1)

† Alcohol abuse and/or illicit drug use

** Silicosis, diabetes, prolonged corticosteroid therapy or other immunosuppressive therapy, hematologic/ reticuloendothelial disease, end-stage renal disease, substantial weight loss (not TB-related) or undernutrition

2009

(N=161)No. (%)

129 (80)

10 ( 6)

4 ( 2)

7 ( 4)

23 (14)

3 ( 2)

1 ( 1)

2011

(N=137)

No. (%)116 (85)

7 ( 5)

2 ( 1)

3 ( 2)

27 (20)

2 ( 1)

2 ( 1)

2012

(N=162)

No. (%)136 (84)

7 ( 4)

2 ( 1)

6 ( 4)

20 (12)

0 ( 0)

1 ( 1)

* 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

Medical conditions*

Cases(N=806)No. ( %)

DiabetesOther Immunosuppressive TherapyEnd Stage Renal DiseaseProlonged Corticosteroid TherapyWeight loss/UndernutritionHematologic/Reticuloendothelial Disease

65 ( 8)41 ( 5)

13 ( 2)2 (<1)6 ( 1)1 (<1)

*Patients could have > 1 medical condition.

HIV Status

Foreign-BornCases

U.S.-BornCases

NegativePositiveRefusedNot OfferedUnknownTotal

573 (89) 28 ( 4) 11 ( 2) 34 ( 5) 0 ( 0)646 (100)

129 (81) 5 ( 3) 3 ( 2) 22 (14) 1 (<1)160 (100)

No. (%) No. (%)

702 (87) 33 ( 4) 14 ( 2) 56 ( 7) 1 (<1) 806 (100)

No. (%)

Total

School No. (%)Preschool 1 (<1)Elementary 40 ( 5)Secondary 51 ( 6)Post-secondary 48 ( 6)Other 49 ( 6)Not a student 617 (77)Total 806 (100)

Region of Birth

Num

ber

of

Case

s

* “Other” includes: Eastern Europe, Latin America/Caribbean, Western Europe

N = 646

N = 646

N = 81

* Per results of pre-immigration screening performed overseas

N = 646

% o

f fo

reig

n-b

orn

case

s

N = 806

* Includes cases with both extrapulmonary and pulmonary sites of disease

Sites of Disease

Cases(N=491)No. ( %)

LymphaticBone/jointPleuralPeritonealGenitourinaryMeningealOther

243 (49)45 ( 9)

41 ( 8)27 ( 5)19 ( 4)16 ( 3)58 (12)

* Includes TB cases with or without concurrent pulmonary disease; patients may have multiple extrapulmonary sites of disease

N = 491

* Chest x-ray or chest CT scan results

*67% of cases without sputum smear results were under 15 years of age

N = 491

N = 806

N = 595

*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)]

17 (11)

12 (10)

5 ( 5)

12 (12)

12 (10)

58 (10)

23 (15)

20 (17)

13 (12)

22 (22)

24 (19)

102 (17)

Year

2008

2009

2010

2011

2012

Total

Cases With Susceptibility Results*

149

120

109

101

124

603

Any DrugResistance†

No. (%)

INH-Resistant**

No. (%)MDR-TB‡

No. (%)

2 (1)

2 (2)

0 (0)

3 (3)

1 (1)

8 (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§ One of these cases was resistant to INH, rifampin, PZA, and ethambutol

Place of Birth

* Culture-confirmed cases with drug susceptibility results available

Total

Cases WithSusceptibility

Results*

495108

603

Any DrugResistance†

No. (%)

94 (19) 9 ( 8)

103 (17)

INH-Resistant**

No. (%)

54 (11) 5 ( 5)

59 (10)

MDR-TB ‡

No. (%)

7 ( 1)

1 ( 1)

8 ( 1) §

U.S.-Born CasesForeign-Born Cases

† 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§ One of these cases was resistant to INH, rifampin, PZA, and ethambutol.

Perc

enta

ge

*

* Percentage among culture-confirmed cases with isoniazid susceptibility results available by place of birth

131 (81)

10 ( 6)

1 ( 1)

3 ( 2)

17 (11)

161

(100)

Presented with symptoms

TB contact investigation

Refugee health exam (domestic)

Pre-immigration exam (overseas)

Other*

Total

2010No. (%)113 (84)

1 ( 1)

1 ( 1)

1 ( 1)

19 (14)

135

(100)

2008No. ( %)

163 (77)

27 (13)

6 ( 3)

5 ( 2)

9 ( 5)

211

(100)

* e.g., occupational screening, other targeted TB testing, etc.

How Identified

2009No. ( %)

2011No. (%)109 (80)

6 ( 4)

2 ( 1)

2 ( 1)

18 (13)

137

(100)

2012No. ( %)

128 (79)

10 ( 6)

10 ( 6)

3 ( 2)

11 ( 7)

162 (100)

N = 595

* “Other” includes: pre-immigration exam (overseas) – 1.5%, other immigration exam – 1%, and employment screening – 1%

Type of provider

N=796

* DOT = Directly Observed Therapy SA = Self-administered

StartedTreatment*

113

CompletedWithin 12 mos.**

No. (%)

106 (94)

CompletedOverall** No. (%)

108 (96)

* Patients for whom < 12 months of therapy is indicated . This excludes: patients with rifampin resistance or meningeal TB, children 14 years of age or younger with disseminated TB, patients who died, and those who moved outside of the U.S. during treatment.

** Treatment completion data as of 7/28/2013

* Some patients are managed by multiple providers throughout disease course

N=796