Tuberculosis Cases Soaring In Seattle

Tom Paulson, Seattle Post-Intelligencer, March 20, 2008

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.

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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.

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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.

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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.”

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