1. Epidemiology of Tuberculosis in Virginia, 2004 Division of TB Control Virginia Department of Health

2. Tuberculosis (TB): A Disease of Public Health Significance Potentially fatal disease transmitted by prolonged contact Long, multidrug treatment regimens increase risk of nonadherence Serious impact of improper/inadequate treatment on community Disproportionate impact on disenfranchised

3. TB Control Challenges in Virginia Rising morbidity in Northern Virginia Greater proportion of TB patients born outside the United States 43 different countries of origin 17 different primary languages (other than English)

4. Number of Reported TB Cases in Virginia, 1986-2004 329

5. TB Case Rates in Virginia, 1996-2004 YearCasesVA RateUS Rate 19963495.38.0 19973495.37.4 19983395.26.8 19993344.96.4 20002924.15.8 20013064.35.6 20023154.55.2 20033324.55.1 20043294.44.9

6. Percent of Reported TB Cases by VA Region: 2003 and 2004 2003 2004

7. Number of Reported TB Cases By VA Region, 2000-2004

8. Number of Reported TB Cases by Age and Sex: VA, 2004

9. Percent of Reported TB Cases by Age: VA, 1996-2004

10. Number of Reported Foreign-Born vs. US-Born TB Cases, VA 1996-2004

11. MDR Cases & Percent of Resistance to Any First Line Drugs: VA, 1998-2004

12. Number of Reported TB/AIDS Cases: VA, 1993-2004

13. Directly Observed Therapy (DOT) DOT is the standard of treatment Patients are observed taking their medications In 2004, 84% of TB cases were on DOT