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All cases of tuberculosis (TB) are reported to the local or state health department, because the disease can spread to others and cause outbreaks. Major health authorities keep track of TB outbreaks and encourage early testing for people who are at risk for the disease. According to the CDC, the rate of TB cases in the US dropped from 2015 to 2016, while North Carolina saw an increase. The most recent data shows the number of reported TB cases in Cabarrus County has tripled between 2016 and 2017. Due the increase in reported active cases of TB Cabarrus County, residents are now considered to live in a county at risk of exposure. Active Tuberculosis Cases Harm Reduction The rapid rise of opioid use, including Heroin, in Cabarrus County has created an epidemic that places additional populations at risk, as well. The sharing of needles, syringes, and other injection equipment provides a direct route of transmission for infectious diseases, placing people who inject drugs (PWID) at high risk. Syringe exchange programs are an evidenced - backed, compassionate, cost-effective way to respond to the personal and community health issues posed by high-risk opioid and injection drug use. According to the Harm Reduction Coalition, approximately 20 percent of HIV/AIDS cases and upwards of 55 percent of hepatitis C cases can be attributed to injection drug use. 2015 2016 2017 0 3 9 The Exchange began operating at Cabarrus Health Alliance in June 2017. The vision of The Exchange is to serve as a welcoming entry point to healthcare services for PWID in Cabarrus County — to engage and care for those who often elect not to seek services due to fear of stigma or lack of knowledge on available resources in their community. Between June and December 2017 approximately 4,740 syringes were given to enrolled participants, while more than 5,600 were returned or collected for proper disposal. Naloxone distribution has been another focus of Cabarrus County's Harm Reduction efforts. A partnership with the North Carolina Harm Reduction Coalition has assisted with the distribution of 601 kits between lune and December of 2017. Through McLeod Addictive Disease Center's Prevention Days and The Exchange, these distributed Naloxone kits have responsible for more than 70 overdose reversals. Strong communication with key stakeholders and community members regarding progress on initiatives specific to the identified priority needs is vital to continued community health improvement. Following review by the Board of Health and Healthy Cabarrus Executive Committee, copies of the State of the County Health Report will be disseminated to the Healthy Cabarrus Advisory Board as well as in target community locations. Targeted locations include local libraries, community centers, park and recreation departments, federally qualified health centers, in addition to other sites with high community member presence. The Healthy Cabarrus Executive Director will plan to present the report annually to local municipal leaders and the Board of Commissioners. AtUchmenl number 1 \n Page 23