Thread: Tuberculosis cases soaring in Seattle

Tuberculosis cases soaring in Seattle
100,000 in King County have latent TB
By TOM PAULSON
P-I REPORTER

Running counter to a nationwide overall decline in tuberculosis rates, TB cases in Seattle and King County have increased and, in 2007, reached a 30-year-record high of 161 active disease cases -- three-quarters of them among people born in other countries.

Tuberculosis, a contagious respiratory disease, today infects one of every three people on the planet and can remain dormant for many years before emerging as illness. About 100,000 King County residents have dormant, or latent, TB infection.

"It's very concerning," said Dr. Masa Narita, head of TB control for Public Health -- Seattle & King County. It is also evidence of the global nature of infectious disease, Narita said, and should serve as a reminder that 2 million people still die from TB every year.

"It is still one of the biggest killers," he said. In 2006, Seattle and King County officials had reported a 16 percent increase, with 145 active TB cases then.

State public health officials also announced Thursday an overall increase of 11 percent in 2007 in reported TB cases statewide, to a total of 291 new cases, with 55 percent in King County.

"This should be a red flag for everyone, including other states," said Kim Field, head of TB control for the state Department of Health. Seattle is an international city, Field said, with a large immigrant population and travelers from all corners of the world.

Changes in the TB trends often show up first in port cities with high rates of foreign travel, she said, foreshadowing future increases in other communities. Most of the new cases, 75 percent, are being identified among immigrants from Southeast Asia, Africa, former Soviet states and Latin America, Field said.

"But there is still a significant amount of ongoing cases related to earlier outbreaks among the homeless, especially in King County," Field said. TB is everywhere, she said, but remains largely neglected when compared with other higher-profile, comparable health threats such as AIDS or malaria.

Dr. Tesfai Gabre-Kidan, an infectious-disease specialist in Seattle who emigrated here from Ethiopia in the 1970s, said TB is a huge problem in developing countries. In Africa, Gabre-Kidan said, the AIDS pandemic has helped to both fuel the spread of tuberculosis while inadvertently obscuring the fact that many reported AIDS deaths are actually TB deaths.

"Here in this country, we used to be very active in attacking the threat of TB," he said. "But we have now let our guard down."

Gabre-Kidan acknowledges that many immigrants bring their TB infections with them when they move here. But perhaps the high rates of active disease seen among the local immigrant populations are attributable not so much to this simple arithmetic, he said, as to the fact that so many of them lack access to adequate, preventive health care services.

"I think this could also be a root cause," Gabre-Kidan said.

In addition to the local increase in TB cases, public health officials are generally concerned about the increasing number of cases of TB that are resistant to treatment. Although only a handful of cases of multidrug-resistant TB (MDR-TB) have been identified in this region, many experts warn that lack of aggressive containment of TB worldwide will lead to a spread of TB strains that are difficult, if not impossible, to treat.

If the moral or community health implications of the ongoing TB problem here is not enough to convince people that this is a serious problem, Narita noted that failure to prevent the spread of this disease will be very costly to taxpayers.

Given the current drugs available to treat TB, Narita explained it can take anywhere from nine months to several years of therapy to clear the infection and cure the disease. Every single patient with routine TB costs about $10,000 to treat, he said, and drug-resistant cases can cost as much as $250,000 dollars per patient.

Harborview Medical Center and the health department already work with area clinics, schools, churches and other organizations to test and then treat people diagnosed with TB.

But Narita said it would require screening a half-million people to try to find all of those with dormant infections and still would be a challenge to identify all infected.

"This is a major health problem for the world," he said. "And we see it reflected here."

ABOUT TUBERCULOSIS

TB is an infection that most severely attacks lung tissue and is caused by an airborne class of microbes known as mycobacteria.

When a person with the illness coughs, the bacteria can be inhaled by another person; however, TB is less contagious than the common cold.

One in three people on Earth carries the bacterial infection, and about 10 percent progress to disease. Nearly 2 million people die from TB every year, making it one of the world's biggest killers.

There are drugs and a vaccine for TB, but none is ideal. Drug treatment of the bacterial infection is cumbersome, time-consuming and expensive. The vaccine is not very effective at preventing the infection.

Public health experts are more concerned than ever about the potential for increased drug-resistant strains of TB worldwide.

A free informational World TB Day forum will be held at 7 p.m. Monday at Town Hall in Seattle.

townhallseattle.org/calendar.cfm.

For more information about TB, see metrokc.gov/health/tbor www.doh.wa.gov/cfh/tb.

P-I reporter Tom Paulson can be reached at 206-448-8318 or tompaulson@seattlepi.com.
http://seattlepi.nwsource.com/health/355858_tb21.html

TB had been almost eradicated in the USA until the fools in dc let the flood gates open!

If the moral or community health implications of the ongoing TB problem here is not enough to convince people that this is a serious problem, Narita noted that failure to prevent the spread of this disease will be very costly to taxpayers.

They are trying to scare you into treating the illegal aliens, with your tax dollars, instead of sending them home. By the way, once you start treating one of them for this, they will receive treatment for everything else that is wrong with them and then the family and will be treated too because they have been exposed to an infected person.

See the problem with this thinking?

Dixie

What concerns me is the large number of them working in food processing plants and restaurants - everywhere.

but in the Ellis Island days, if you did not pass a physical exam, you got the next ship back from whence you came. I saw the Ellis Island records of my grandfather. A doctor examined him, he needed a doctor's OK to continue his journey into America.

They all flood the Harbor View hospital emergency room.

The son of one of our friends, who is now a practicing orthopedist in Seattle, contracted TB in Seattle when he was completing his residency at one of the local hospitals three years ago. Fortunately, he caught it early and successfully treated it with drugs. Unfortunately, most people aren't so lucky and don't catch it early enough. According to this young doctor, TB is near epidemic status...in several major cities, but it is all being covered up by the media and politicians.

We are importing poverty and squallor from all of the third world countries! I feel like I'm living in one giant petrie dish! Just wait until we have National Health Care...we haven't seen anything yet!

Don't people who come in here on visa's or with a passport have to have health checks first anymore ?

Again, as I commented on another article, "our" FAMILIES are at the mercy of ILLEGALS and their Anchor Babies being murdered, raped, infected with disease, or robbed. But NOT to worry the Chamber of Commerce will get their "cheap labor" increasing "their privatized" PROFITS, thanks to Bush and the Congressional Leadership!!

Originally Posted by SOSADFORUS

Don't people who come in here on visa's or with a passport have to have health checks first anymore ?

Doesn't help when millions sneak over our southern border.