15.5

11.2

12.311.9

9.2 9.28.8 8.9

9.5 9.69.1

8.48.9

8.4 8.2

9.6 8.9

6.35.8 5.6

5.2 5.1 4.9 4.8 4.6 4.4 4.23.8 3.6 3.4 3.2 3.0 3.0 3.0

0.0

2.0

4.0

6.0

8.0

10.0

12.0

14.0

16.0

18.0

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Cas

es

pe

r 1

00

,00

0

Hawaii Rate U.S. Rate

TB Case RatesHawaii vs. United States, 1999–2015

U.S. in 2015Hawaii had the 2nd

Highest TB Case Rate

Updated as of December 1, 2016

Updated as of December 1, 2016

Reported TB CasesHawaii, 1930–2015

1060

717

339

293270

167196

136 115 117 136 127

0

200

400

600

800

1000

1200

1930 1940 1950 1960 1970 1980 1990 2000 2010 2012 2014 2015

No

. of

case

s

Year

114122 124

117 115123 117 115

136127

0

20

40

60

80

100

120

140

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

No

. of

case

s

Year

Updated as of December 1, 2016

Reported TB CasesHawaii, 2006–2015 Avg. = 121

County

No. of Cases Case Rates(per 100,000 population)

Population EstimatesJuly 1, 2015

2014 2015 2014 2015 2014 2015

Hawaii 8 11 4.1 5.6 194,190 196,428

Honolulu 112 98 11.3 9.8 991,788 998,714

Kauai 2 1 2.8 1.4 70,475 71,735

Maui 14 17 8.6 10.3 163,019 164,637

TOTAL 136 127 9.6 8.9 1,419,561 1,431,603

TB Cases and Case Rates by CountyHawaii, 2014–2015

Updated as of December 1, 2016

Note: Population estimates used to compute case rates were obtained from U.S. Census Bureau: State and County QuickFacts. Data derived from Population Estimates, American Community Survey, Census of Population and Housing, State and County Housing Unit Estimates, County Business Patterns, Nonemployer Statistics, Economic Census, Survey of Business Owners, Building Permits, Consolidated Federal Funds Report (http://quickfacts.census.gov/qfd/states/15000.html) (accessed June 20, 2016).

204

102

60

232 1.8 1.4 0.3 0.2 0.1 0.2

0

100

200

300

400

500

600

0

100

200

300

400

500

600

1920 1930 1940 1950 1960 1970 1980 1990 2000 2010 2015

TB Deaths TB Death Rate

Updated as of December 1, 2016

TB Deaths and Death RatesHawaii, 1920–2015

No. of TB Deaths Death Rate per 100,000

1

3 3

4

2 2

5

2

4

3

0.10.2 0.2 0.3

0.1 0.10.4

0.1 0.3 0.2

0

1

2

3

4

5

0

1

2

3

4

5

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

TB Deaths TB Death Rate

Updated as of December 1, 2016

TB Deaths and Death RatesHawaii, 2006–2015

No. of TB Deaths Death Rate per 100,000

<15 15-24 25-44 45-64 ≥65

0%

5%

10%

15%

20%

25%

30%

35%

Age Group

Pe

rce

nta

ge o

f C

ase

s

Hawaii, 2015

Percent of TB Cases by Age Group and GenderHawaii vs. United States, 2015

<15 15-24 25-44 45-64 ≥65

0%

5%

10%

15%

20%

25%

30%

35%

Age Group

Pe

rce

nta

ge o

f C

ase

s

United States, 2015

Female MaleUpdated as of December 1, 2016

Pulmonary Only72% (92)

Pulmonary and Extrapulmonary*

17% (21)Lymphatic

3% (4)

Pleural2% (2)

Otherᶧ6% (8)

Extrapulmonary Only11% (14)

*Includes pulmonary combined with: pleural (9), pleural and lymphatic (1) , pleural and bone (1) , lymphatic and bone (1), lymphatic (2), laryngeal (1), urogenital (1), peritoneal (1), meningeal (2), stomach (1), colon (1) Includes colon (2), laryngeal (1), bone (1), eye/ear (1), urogenital (2), urogenital/stomach (1)

Updated as of December 1, 2016

TB Cases by Major Site of DiseaseHawaii, 2015

N=127

11% (9)

6% (6)

12% (12) 13% (12)

1% (1)

9% (7)

22% (20)

12% (11)

5% (5)

0% (0)0% (0)

3% (3)

0% (0)

1% (1)0% (0) 1% (1)

0%

5%

10%

15%

20%

25%

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

% R

esi

stan

t

Isoniazid MDR TB

1% (1)

7% (6)

4% (4)

0% (0)

Updated as of December 1, 2016

Primary Anti-TB Drug Resistance*

Hawaii, 2006–2015

U.S. in 2015INH-R = 9.2%

MDR TB = 1.2%

*Cases are culture positive with initial drug susceptibility testing done. Isolates may be resistant to other drugs. Excludes cases with susceptibility testing not done or unknown for isoniazid and rifampin.

114122 124 117 115

123 117 115

136127

45%

62%

51%56%

78%

88%

96% 97% 99% 96%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

0

50

100

150

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

No. of Hawaii Cases % Tested for HIV

Updated as of December 1, 2016

Trends in HIV Testing Persons with TBHawaii, 2006–2015

No. of Cases Percentage

114122 124 117 115

123 117 115

136127

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

0

20

40

60

80

100

120

140

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

No. of Hawaii Cases Foreign-born (Hawaii Definition) Foreign-born (CDC Definition)

Trends in TB Cases and Percentage ofForeign-born Persons (Hawaii vs. CDC Definition)

Hawaii, 2006–2015No. of Cases Percentage

Updated as of December 1, 2016

United States14% (18)

Federated States of Micronesia

11% (14)

Vietnam 4% (5)

Other Countries* 6% (8)

Republic of the Marshall Islands

6% (8)

China2% (3)

Loas2% (2)

Philippines54% (69)

Countries of Birth of All PersonsReported with TB, Hawaii, 2015

N=127

*Other countries include: American Samoa (1), Burundi (1), Guam (1), Korea (1), Mongolia (1), Taiwan (1), Thailand (1), Palau (1)

Updated as of December 1, 2016

Federated States of Micronesia

13% (14)

Vietnam 5% (5)

Other countries*

7% (8)

Republic of the Marshall Islands

7% (8)

China 3% (3)

Loas2% (2)

Philippines63% (69)

Countries of Birth of Foreign-born PersonsReported with TB, Hawaii, 2015

N=109

*Other countries include: American Samoa (1), Burundi (1), Guam (1), Korea (1), Mongolia (1), Taiwan (1), Thailand (1), Palau (1)

Updated as of December 1, 2016

Country of Birth 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Total

FSM* 9 10 12 10 10 8 9 5 11 14 98

Marshall Islands 10 10 8 7 8 6 5 5 8 67

American Samoa 2 1 2 1 1 1 8

Guam 1 2 2 1 6

CNMI† 1 1 1 1 4

Palau 1 1

TOTAL: 12 24 23 18 19 18 16 12 17 25 184Percent of Cases: 11% 20% 19% 15% 17% 15% 14% 10% 13% 20%

TB Cases Born in the U.S.-Affiliated Pacific IslandsHawaii, 2006–2015

*FSM = Federated States of Micronesia which includes Chuuk, Kosrae, Pohnpei, and Yap†CNMI = Commonwealth of the Northern Mariana Islands

Updated as of December 1, 2016

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Republic of theMarshall Islands

FederatedStates of

Micronesia

Philippines Vietnam China All Foreign-born

Unknown* <1 1-4 ≥5

Percent of Foreign-born TB Cases by Time of Residence in U.S. Prior to Diagnosis

Hawaii, 2015

*Foreign-born TB cases for whom information on length of residence in the U.S. prior to diagnosis is missing or unknown

Updated as of December 1, 2016