2014 TUBERCULOSIS FACT SHEET A Profile of Mecklenburg County Reported Cases

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1 OVERVIEW T uberculosis (TB) is a disease caused by bacteria called Mycobacterium tuberculosis. TB usually affects the lungs, but it can also affect other parts of the body. TB is spread through the air from one person to another. The bacteria are put into the air when a person with active TB disease of the lungs or throat coughs or sneezes. People nearby may breathe in these bacteria and become infected. If not treated properly, TB disease can be fatal. Worldwide, TB affects about 9 million people each year, killing about 2 million. In the United States 9,412 TB cases were reported in 2014 with 536 deaths related to TB disease occurring in 2011, the latest year for which complete data is available (Centers for Disease Control, 2014 TB Surveillance Report). TB Case Reports Decline, However Challenges Persist TB case rates for the nation have declined, following a resurgence of the disease between 1985 and In 2014, the number of TB cases reported in the nation and case rate (3.0 cases per 100,000) declined; a decrease of 2.2% from In Mecklenburg County TB case rates declined from 14.5 cases per 100,000 persons in 1995 to 2.2 cases per 100,000 persons in Despite this overall improvement, the percentage decrease in rates has slowed in recent years. In addition, the emergence of drug resistant TB strains and increased reports among foreign-born populations create continued challenges in TB eradication. Prepared by: Mecklenburg County Health Department, Epidemiology Program 04/

2 Data Source: North Carolina Electronic Disease Surveillance System (NC EDSS) Prepared by: Mecklenburg County Health Department, Epidemiology Program 04/

3 MECKLENBURG TB CASE REPORTS: 2014 DEMOGRAPHIC PROFILE In 2014, 22 TB cases (a rate of 2.2 cases per 100,000 persons) were reported in Mecklenburg County. The 2014 case rate for Mecklenburg was similar to the State (2.0) and lower than the Nation (3.0). In comparison to peak reports in 2006 (55 reported cases), Mecklenburg TB reports during 2014 declined by 60%. Age, Gender and Racial/Ethnic Differences The majority of the 2014 TB cases were reported among persons 50 years and over (27%). Females (12 cases or 55%) were more likely than males (10 cases or 45%) to be reported with TB. While overall reports and case rates of TB have declined for the county, racial and ethnic minorities remain disproportionately impacted by tuberculosis. Non-Hispanic Whites accounted for 9% of new TB cases in In comparison, non Hispanic African Americans represented 36% of reports while Hispanic/Latinos were 23% and non-hispanic Asian/Pacific Islanders were approximately 27% of new TB case reports for the county. Several factors contribute to these differences in reports, including increased reports among Foreign born persons, many of whom are racial/ethnic minorities. *Due to rounding, percentages may total more than 100% Prepared by: Mecklenburg County Health Department, Epidemiology Program 04/

4 RISK FACTORS FOR TUBERCULOSIS Increased TB case reports are associated with several risk factors, including: being foreign-born having a history of substance abuse being homeless being a resident of a long-term care facility or a correctional facility co-infection with HIV, and being a health-care worker Based upon the past five years of countylevel data, there have been limited to no reports of TB disease in long-term care facilities, correctional facilities or among health-care workers. TB cases co-infected with HIV have declined over time, from 16% of TB reports in 2011 to 5% of TB reports during Reports of being homeless within the past year among TB cases have ranged from 3-7%. In 2014, there were no reports of homelessness among TB cases. Prepared by: Mecklenburg County Health Department, Epidemiology Program 04/

5 Country of Origin: U.S. and Foreign born Case Reports In general TB case reports among US born persons has declined over time, while the proportion of TB cases among foreign-born individuals has increased. Foreign-born TB cases increased from 34% of total case reports in 2008 to 68% of total case reports in During 2014, non-hispanic Asians accounted for the majority of foreign born TB reports (40%), while non- Hispanic African Americans (72%) represented the majority of US Born TB cases Mecklenburg TB Reported Cases: US Born and Foreign Born Cases (% Distribution of Race/Ethnicity) US BORN Reported TB Cases by Race Total US Born Cases: 7 FOREIGN BORN Reported TB Cases by Race Total Foreign Born Cases: TB cases were reported in Prepared by: Mecklenburg County Health Department, Epidemiology Program 04/