As the number of tuberculosis (TB) cases in the U.S. declined to an all-time low in 2009, King County saw a rise in TB cases, and continues to see rates of active TB cases nearly double that of the United States as a whole, reflecting the ongoing challenge of controlling TB in a global community. This is at a time when the downturn in the economy has forced cuts in recent years to critical services provided by Public Health – Seattle and King County, including the TB control program.

The number of people diagnosed with active TB in King County rose to 130 in 2009, from 121 cases in 2008; the county rate of 6.8 per 100,000 people compares to the national rate of 3.8 per 100,000. More than 80 percent of active TB cases in King County were born outside the United States. Globally, TB is an ongoing epidemic that infects one-third of the world’s population and kills two million people worldwide every year.

These new findings are included in the 2009 Annual Report on Tuberculosis for King County, found at www.kingcounty.gov/health/tb.

“King County is not immune from the global TB epidemic. That’s why investments in our TB program continue to be critical to control its spread here, and prevent the development of multi-drug resistant strains that are very expensive to treat,” said Dr. David Fleming, director and public health officer for Public Health. “We are doing the best we can to hold back the spread of TB, but it has been challenging given the program cuts we’ve had to make over the past several years in this difficult budget climate.”

Public Health’s TB control program works to ensure that people with active TB are diagnosed and cured and that their contacts at highest risk of infection are evaluated, and treated if appropriate, so that TB does not spread to others. In 2009 the TB control program investigated 899 people who were close contacts of people with active TB disease. Of those investigated, 134 were diagnosed with latent TB infection and received treatment.

Because of budget cuts over the past two years, the TB Control Program has reduced staff and now limits services to the highest priority cases and contacts. Multidrug resistant forms of the disease, which flourish in communities where the disease is not well controlled, cost approximately $250,000 per person to cure.

“TB control is an essential investment in the health of our communities, and we can’t let down our guard,” said Dr. Masa Narita, TB control officer for Public Health. “TB is curable and preventable, but controlling it takes ongoing work.”

Approximately 100,000 people in King County have latent, or dormant, TB infection. While not contagious now, they could develop TB in the future and potentially infect others.

Additional key findings from the 2009 Annual Report include:

• 84 percent of infected individuals were born outside of the U.S., primarily Southeast Asia and India, East Africa and Central America.
• All non-white races continue to have disproportionately high rates of TB.
• 18 people (13 percent) treated for active TB were resistant to at least one TB medication.

Background on TB

Tuberculosis, also called TB, is an infectious disease caused by a bacterium named Mycobacterium tuberculosis. TB often involves the lungs (pulmonary TB) but can infect almost any organ in the body. TB is almost always curable with antibiotics that are readily available in countries such as the United States.

People with active TB disease are made sick by bacteria that are active in their body. People with latent, or dormant, TB infection are not sick because the germ is inactive inside their body, and they cannot spread TB infection to others.

To view the 2009 summary data and for more information on Public Health’s TB Control Program and activities visit www.kingcounty.gov/health/tb.