Since January of 2016, we have seen an increase of multidrug-resistant tuberculosis (MDR TB) in Minnesota. The increase in these rates is due to an MDR TB outbreak within the Hmong community of the east metro. This outbreak is concerning because to get rid of the disease, we need stronger medications for a longer treatment period. Many Hmong elders were exposed to TB before coming to the United States and were treated when they arrived in Minnesota years ago. However, if they had been exposed to MDR TB, the treatment they received might not have worked. As they get older and have other health conditions, the MDR TB germs are waking up and making the person sick. Stopping this outbreak will take a community effort. If your loved one has been contacted by Ramsey County, please assist them in getting to the TB Clinic or their healthcare provider to get tested.

It is important to understand tuberculosis (TB) and learn how to protect yourself and your family. TB is a disease caused by bacteria that usually attacks the lungs. TB germs have two phases:

1. Latent TB infection: the TB germs are sleeping/not active, cannot spread to others
   and
2. Active TB disease: the TB germs are awake and causing sickness, can spread when person coughs, sneezes, sings, or talks.

People who have symptoms of active TB disease, or anyone who may have been exposed to TB, need to see their health care provider, get tested, and treated. Signs of TB disease include coughing for three weeks or longer, coughing up blood or brown-colored material from your lungs, shortness of breath, pain in the chest, sweating at night, fever or chills, and unintentional weight loss.

Fear of TB can cause some people to feel isolated and afraid. A person with TB is not always an immediate threat to the public. For TB to spread to another person, it typically requires contact with someone who has had active TB for a long time. If a person with active TB takes their medications as prescribed, and their doctor says so, they can be in public without worrying about making anyone sick.

As a response to the MDR-TB outbreak, the Minnesota Department of Health (MDH), the MDH Hmong Advisory Group and iDream.tv have produced educational videos on TB and MDR TB. The purpose of the videos is to inform the Hmong community about TB and MDR TB. The videos show the importance of public health screening for people who have been exposed to TB and explain prevention efforts you may see in your community. The video project will be released December 2018 and contain a live-action Hmong language video and two short animation videos, one in English, and one in Hmong.

To help protect yourself, your loved ones and community from TB, follow these steps:

• Watch for symptoms of TB in yourself and others.
• See your health care provider if you notice symptoms of TB to get tested.
• Follow instructions for taking TB medicine, even if you start to feel better.
• Stay home when you are sick and ask friends and family to stay home when they are sick.

For more information about TB and the MDR TB videos, go to www.health.state.mn.us/tb.