News
King County Health: More
Potent TB Strain Spreading
General population in Seattle is increasingly at risk
from antibiotic-resistant, communicable disease
K
ing County, Wash., public
health officials say a strain
of tuberculosis, called
PCR0001, which is responsible for
76 cases in the local homeless
population since 2002, is now
being transmitted among the
broader community as well.
Health officials say they’re wor-
ried because the strain appears
more likely to infect others and
cause active TB disease than the
more commonly seen strains.
“We aren’t immune in King
County from the global epidemic
or the changing nature of the dis-
ease itself,” said Dr. David
Fleming, Director and Health
Officer for Public Health - Seattle
& King County. “The wider
spread of what appears to be a
more potent strain is concerning,
and it’s an important example of
why we can’t afford to relax our
efforts in controlling 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
inactive, or latent, TB infection are
not sick because the germ is inac-
tive inside their body, and they
cannot spread TB infection to oth-
ers.
Of the 116 active TB cases diag-
nosed in King County in 2010, six
were caused by the PCR0001
strain, including three outside the
homeless population.
The TB Control Program has
made focused efforts in recent
years that have helped to control
the spread of the PCR0001 strain
among the homeless population,
and is now prioritizing its work on
controlling the spread of the strain
more broadly.
Approximately one third of the
world’s population is infected
with tuberculosis, and two million
people die from it every year.
King County’s active TB rate is
consistently among the highest for
any local area in the country,
reflecting the global nature of
King County’s community. Of the
116 people diagnosed with active
TB in 2010, 84 percent were born
outside the United States.
Public Health – Seattle & King
County’s TB Control program
ensures that people with active, or
infectious, TB are diagnosed and
treated until cured. They also
evaluate and treat, if appropriate,
people exposed to infectious TB,
so it does not continue to spread.
Everyday, TB program staff
ensure that infectious TB patients
adhere to drug treatment, which
consists of multiple medications
for six months or longer. More
than 2,800 clients make almost
12,000 visits to the TB clinic
annually for treatment. The TB
Control Program also evaluates
immigrants and refugees who are
suspected of having active TB.
However, because of state and
King County budget crises, the
TB Control Program faces contin-
ued funding challenges. Over the
past several years, the TB
Program has reduced staff and
now limits services to the highest
priority cases and contacts.
“We estimate approximately
100,000 people in King County
have latent, or dormant, TB infec-
tion. While they aren’t contagious
now, some will develop active TB
in the future and could infect oth-
ers,” said Dr. Masa Narita, TB
Control Officer for Public Health.
“TB is curable and preventable,
but controlling TB is an ongoing
challenge, especially with fewer
resources to protect the communi-
ty.”
Highlights of 2010 TB data:
116 people were reported with
active TB, for a rate of 6 per
100,000 people, a decrease from
130 cases in 2009. This was
noticeably higher than the U.S.
rate of 3.8 cases per 100,000 peo-
ple.
84 percent of infected individu-
als were born outside of the
United States. Of these individu-
als, 67 (62 percent) came from
David Flemming
five countries: the Philippines,
Somalia, Ethiopia, Vietnam and
India.
People of color continue to have
disproportionately high rates of
TB, with the highest case rate
among individuals who identify
their race as black (26.4 cases per
100,000) or Asian (21.4 per
100,000).
20 people (17 percent) treated
for active TB were resistant to at
least one TB medication.
Two multi-drug resistant TB
(MDR-TB) cases were diagnosed
in King County in 2010. Multi-
drug resistant cases are much
more expensive to treat, costing
up to $250,000 each.
To view the 2010 summary data
and for more information on
Public Health’s TB Control
Program and activities, visit:
www.kingcounty.gov/health/tb.
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Page 10 The Portland Skanner march 30, 2011