The Epidemiology of Tuberculosis
in Minnesota, 2006-2010
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
Tuberculosis Morbidity,
Minnesota, 2006-2010
Year
2006
2007
2008
2009
2010
No. Cases
217
238
211
161
135
Rate*
4.2
4.6
4.0
3.1
2.6
* Cases per 100,000 population. Rates were calculated using state
population estimates from the U.S. Census Bureau.
Tuberculosis Incidence Rates per 100,000
Population, United States and Minnesota, 1996-2010
United States
12
Minnesota
Healthy People 2000
Objective*
Healthy People 2010
Objective
8
6
4
2
0
19
96
19
97
19
98
19
99
20
00
20
01
20
02
20
03
20
04
20
05
20
06
20
07
20
08
20
09
20
10
Cases per 100,000
10
Year of Diagnosis
Number of Cases
Number of Tuberculosis Cases by Place
of Birth, Minnesota, 2001-2010
240
220
200
180
160
140
120
100
80
60
40
20
0
Total
Foreign-Born
U.S.-Born
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
Year of Diagnosis
Number of Cases and Incidence of Tuberculosis
by Location of Residence, Minnesota, 2006-2010
Location of Residence
2006
No. (rate)*
2007
2010
2009
2008
No. (rate)* No. (rate)* No. (rate)* No. (rate)*
Hennepin County
95 (8.4)
114 (10.0)
97 (8.5)
61 (5.3)
67 (5.8)
Ramsey County
44 (8.8)
47 ( 9.4)
44 (8.8)
41 (8.1)
34 (6.7)
Suburban Twin Cities Metro† 27 (2.4)
26 ( 2.2)
23 (2.0)
26 (2.2)
16 (1.3)
Olmsted County
15 (10.9)
20 (14.3)
4 (2.8)
8 (5.6)
6 (4.2)
Other Counties
36 (1.6)
31 ( 1.4)
43 (1.9)
25 (1.1)
12 (0.5)
217 (4.2)
238 (4.6)
211 (4.0)
161 (3.1)
135 (2.6)
Total
* Rate per 100,000 population. Statewide total rates were calculated using state population estimates
from the U.S. Census Bureau.
† Anoka, Carver, Dakota, Scott, and Washington counties
Tuberculosis Disease,
Minnesota, 2010
Tuberculosis Cases by
Age Group and Place of Birth,
Minnesota, 2006-2010
< 5 yrs
5 - 14 yrs
15 - 24 yrs
25 - 44 yrs
45 - 64 yrs
>= 65 yrs
100
Percentage of
Cases
80
60
40
20
0
Foreign-Born
U.S.-Born*
Place of Birth
* Includes U.S.-born children of foreign-born parent(s)
Cases of Tuberculosis by Risk Category,
Minnesota, 2006-2010
Risk Category*
2006
(N=217)
No. (%)
2009
2008
2010 Cumulative
2007
(N=238) (N=211) (N=161) (N=135) (N=962)
No. (%) No. (%) No. (%) No. (%) No. (%)
Foreign-born
175 (81)
203 (85) 155 (73) 129 (80) 110 (81)
Substance abuse†
772 (80)
13 ( 6)
16 ( 7)
21 (10)
10 ( 6)
7 ( 5)
67 ( 7)
Homeless
5 ( 2)
6 ( 3)
11 ( 5)
4 ( 2)
3 ( 2)
29 ( 3)
HIV-infected
8 ( 4)
12 ( 5)
11 ( 5)
7 ( 4)
6 ( 4)
44 ( 5)
31 (14)
39 (16)
23 (11)
23 (14)
23 (17)
139 (14)
Inmate
3 ( 1)
2 ( 1)
5 ( 2)
3 ( 2)
4 ( 3)
17 ( 2)
Nursing home resident
1 (<1)
1 (<1)
3 ( 1)
1 ( 1)
3 ( 2)
9 ( 1)
Other medical condition**
* Risk categories are not mutually exclusive.
†
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
Tuberculosis Cases by HIV Status and
Place of Birth, Minnesota, 2006-2010
HIV Status
Negative
Positive
Refused
Not Offered
Unknown
Total
Foreign-Born
Cases
No. (%)
U.S.-Born
Cases
No. (%)
662 (86)
37 ( 5)
17 ( 2)
55 ( 7)
1 (<1)
772 (100)
133 (70)
7 ( 4)
1 ( 1)
48 (25)
1 ( 1)
190 (100)
Total
No. (%)
795
44
18
103
2
(83)
( 5)
( 2)
(11)
(<1)
962 (100)
Foreign-Born Tuberculosis Cases by
Region of Birth and Year of Diagnosis,
Minnesota, 2006-2010
Number of Cases
140
120
100
2006
2007
2008
2009
2010
80
60
40
20
0
South/
Southeast
Asia
SubSaharan
Africa
East Asia/
Pacific
Latin
America/
Caribbean
Region of Birth
Eastern
Europe
Foreign-Born Tuberculosis Cases by
Visa Status Upon Arrival in the U.S.,
Minnesota, 2006-2010
Unknown
(2%)
Other
(15%)
Immigrant
(32%)
(N = 772)
Refugee
(51%)
“TB Class” Notifications* Among Foreign-Born
Tuberculosis Cases Who Arrived in the U.S. as
Immigrants/Refugees Within 1 Year Prior to
Diagnosis, Minnesota, 2006-2010
Class B1
(17%)
Class B2
(1%)
Unknown
(34%)
(N = 143)
* Per results of pre-immigration screening performed overseas
No Class
(47%)
Foreign-Born Tuberculosis Cases by Interval
Between Arrival in U.S. and Diagnosis of
Tuberculosis, Minnesota, 2006-2010
Unknown
(<1%)
<1 year
(22%)
>5 years
(44%)
1-2 years
(19%)
(N = 772)
3-5 years
(16%)
Tuberculosis Cases by Site of Disease and
Place of Birth, Minnesota, 2006-2010
Site of Disease
Foreign-Born
Cases
No. (%)
U.S.-Born
Cases
No. (%)
Total
No. (%)
Pulmonary
Extrapulmonary
Both*
Total
348 (45)
340 (44)
84 (11)
772 (100)
129 (68)
31 (16)
30 (16)
190 (100)
477 (50)
371 (39)
114 (12)
962 (100)
*
TB cases with both pulmonary and extrapulmonary sites of disease,
including miliary TB
Tuberculosis Cases by Drug Susceptibility
Patterns and Year, Minnesota, 2006-2010
Year
Cases With
Susceptibility
Results*
Any Drug
Resistance†
No. (%)
INHResistant**
No. (%)
MDR-TB‡
No. (%)
2006
177
27 (15)
18 (10)
2 (1)
2007
176
22 (13)
17 (10)
3 (2)
2008
149
23 (15)
17 (11)
2 (1)
2009
120
20 (17)
12 (10)
2 (2)
2010
109
12 (11)
5 ( 5)
0 (0)
Total
731
104 (14)
69 ( 9)
9 (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
§ Two
of these cases were resistant to INH, rifampin, PZA, and ethambutol.
Tuberculosis Cases by Method of Case
Identification, Minnesota, 2006-2010
TB Contact
Investigation
(7%)
Refugee Health
Exam (domestic)
(5%)
Pre-immigration
exam (overseas)
(2%)
Other
(7%)
Presented with
Symptoms
(80%)
(N = 962)
Tuberculosis Cases by Mode of Treatment
Administration, Minnesota, 2006-2010
100%
80%
60%
40%
20%
0%
2006
DOT
2007
2008
Some supervision, not DOT
2009
2010
Self-administered
Tuberculosis Cases by Mode of Treatment
Administration and Type of Health Care
Provider, Minnesota, 2006-2010
100%
Self-administered
80%
60%
Some supervision,
not DOT
DOT
40%
20%
0%
Public
Private
Type of Provider
Completion and Length of Therapy Among
Tuberculosis Cases by Type of Health Care
Provider, Minnesota, 2009
Type of Provider
Public
Private
Total
Completed
Completed
Overall
Started Within 12 mos.
Treatment*
No. (%)
No. (%)
88
65
79 (90)
85 (97)
54 (83)
58 (89)
153
133 (87)
143 (93)
* Patients for whom < 12 months of therapy is indicated - - i.e., excluding patients with
rifampin resistance or meningeal TB and patients 15 years of age or younger with
miliary TB