HomeMy WebLinkAbouttuberculosis-in-alameda-county-2015-archiveSEX AND AGE
As in previous years, men comprised a
higher percentage (51.5%) of TB cases than
women (Table 1). The average annual rate
among men from 2013 to 2015 was 9.6 per
100,000, approximately 1.3 times the rate in
women (7.0 per 100,000).
Also similar to 2014, the greatest propor-
tion of incident TB cases occurred among
adults age 65 years and older (34.5%),
which had the highest average case rate of
22.8 per 100,000 compared to other age
groups; 89.1% of TB incident cases oc-
curred among individuals age 25 and older.
In 2015, one case of TB occurred in a child
younger than five years of age (Table 1).
RACE/ETHNICITY
The majority of TB cases in 2015 (93.5%)
occurred among people of color (Table 1).
Cases occurred predominantly in Asians/
Pacific Islanders (71.2%), followed by Black
Tuberculosis in Alameda County 2015
OVERVIEW
In 2015, 139 tuberculosis (TB) cases were re-
ported to Alameda County (excluding the City of
Berkeley). This represents a 28.7% increase in
cases compared to 2014 and more comparable to
rates observed in 2011 and 2012 (Figure 1). The
2015 TB case rate in Alameda County was 9.5
cases per 100,000 residents, ranking fourth
among all jurisdictions in California and is 72.7%
higher than the California state rate of 5.5 cases
per 100,000 residents. Compared to other Bay
Area jurisdictions, the rate in Alameda County
continues to rank lower than San Francisco (11.1
per 100,000) and Santa Clara (10.3 per 100,000)
counties, but is higher than Contra Costa (4.1
per 100,000), Marin (3.4 per 100,000) and San
Mateo (7.5 per 100,000) counties.
141 149
134
156
178
132 136
114 108
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# Cases Alameda County California U.S.
Figure 1. Annual Tuberculosis Cases in Alameda County
2006-2015
(11.5%) and Latino residents (10.1%) (Table 1). Rates among each race/ethnicity group have remained stable in recent
years; from 2013-2015, Asian/Pacific Islanders had the highest average annual case rates (20.0 per 100,000), almost
three times the rate among Non-Hispanic Blacks (7.2 per 100,000), almost five times that of Latinos (4.2 per 100,000),
and ten times the rate for Non-Hispanic Whites whose average annual case rate was 1.8 per 100,000. When examined
by place of birth, the majority of U.S.-born cases occurred among Black residents (45.0%), while 83.2% of cases born
outside of the U.S. were Asian/Pacific Islanders.
Number of
Cases
(N=139)Percent
Average
Case Rate
per 100,000
Sex Males 71 51.1%9.6
Females 68 48.9%7.0
Age Group 0-4 yrs 1 0.7%n/a
5-14 yrs 1 0.7%n/a
15-24 yrs 13 9.4%9.9
25-44 yrs 33 23.7%6.8
45-64 yrs 43 30.9%18.3
65+ yrs 48 34.5%22.8
Non-Hispanic Black 16 11.5%7.2
Asian / Pacific Islander 99 71.2%20.0
Amer Ind / Native AK 1 0.7%n/a
Latino 14 10.1%4.2
White 9 6.5%1.8
Birthplace United States 18 12.9%1.7
Outside of United States 121 87.1%21.0
Race /
Ethnicity
Table 1: Incident TB Cases (2015) and Average Case Rates
(2013-2015), Alameda County
Page 2 Tuberculosis in Alameda County 2015
PLACES OF RESIDENCE
As in previous years, a majority of TB cases oc-
curred among residents of Oakland (40.3%), fol-
lowed by Fremont (15.1%) and Hayward (12.2%)
and Union City (9.4%). The five-year average TB
rate in is highest in Downtown, Uptown and
East Oakland (over twice the five-year county
average of 8.8 cases per 100,000), followed by
Northern and Central Fremont (one to one-and-a
-half times the county average) (Figure 3).
CLINICAL CHARACTERISTICS
Of the TB cases reported in 2015, 70.5% were
pulmonary-only cases, 18.0% were extrapulmon-
ary only and 11.5% were both pulmonary and
extrapulmonary (Table 2). Of the 114 pulmonary
cases, 42.1% were smear-positive and 33.3% had
evidence of cavitary disease, both of which are
indicators of increased infectiousness. HIV is the
most important risk factor for progression from
latent TB infection to TB disease; in 2015, 4.3%
of TB cases were co-infected with HIV.
DRUG RESISTANCE
In 2015, 14 (10.1%) TB cases demonstrated resis-
tance to at least one first-line drug used to treat
TB (isoniazid, rifampin, ethambutol and pyrazi-
namide). Of those, 12 of 14 were resistant to
isoniazid, nine of which were resistant to isoni-
azid only. There were three multi-drug resistant
TB cases (resistant to both isoniazid and ri-
fampin) in Alameda County in 2015, an increase
from one case in 2014 and none in 2013. All
cases with drug resistance in 2015 were born out-
side of the United States.
1000 San Leandro Blvd, First Floor, San Leandro, CA 94577
Phone: (510)667-3096 | Fax: (510)273-3916
Website:
http://www.acphd.org/tb.aspx
PLACES OF BIRTH
In 2015, 121 of the 139 TB cases (87.1%) occurred among individuals born outside
of the U.S., who most often came from the Philippines, China, India, and Vietnam
(Figure 2). Compared to 2014, more cases were born in China (17.3% vs. 12.0% in
2014), Vietnam (10.1% vs. 6.5% in 2014) and Ethiopia (4.3% vs. 1.0% in 2014), and
fewer cases were born in India (10.1% vs. 13.0% in 2014) and Mexico (2.2% vs.
6.5% in 2014). The average annual case rate in 2013-2015 for individuals born out-
side of the U.S. in Alameda County was 21.0 per 100,000, more than twelve times
the rate for individuals with TB who were born in the U.S. (1.7 per 100,000).
Figure 2: Incident TB Cases (2015)
by Place of Birth, Alameda County
Table 2: Clinical Characteristics of Incident TB Cases (2015)
Alameda County
Number of
Cases Percent
Pulmonary only 98 70.5%
Extrapulmonary only 25 18.0%
Both 16 11.5%
Sputum smear Positive 48 42.1%
Negative 60 52.6%
Not done 6 5.3%
Cavitary disease Present 38 33.3%
Absent 76 66.7%
Comorbidities HIV/AIDS 6 4.3%
Diabetic 30 21.6%
End-stage renal disease 7 5.0%
Other immunosuppresion 8 5.8%
Any drug resistance 14 10.1%
INH resistance 12 8.6%
Resistance to INH only 9 6.5%
Multi-drug resistance 3 2.2%
Drug
resistance
Among cases with any pulmonary disease (N=114)
Site of
disease
Figure 3: Alameda County TB Rates by Zip Code, 2011-2015
For questions or additional information, contact:
Alameda County Public Health Department
Tuberculosis Control Unit