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Many locals may have TB and not even know it

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SEATTLE -- Local health workers are dealing with a wave of new tuberculosis cases, but they warn of an even bigger potential crisis. While public health agencies focus on active TB cases, there's a huge number of people with inactive, or latent TB. And few of them realize they have it. In King County alone, there are 100-thousand people with inactive TB.

Dr. Jeff Duchin, the public health officer for Seattle and King County, calls it a real problem. "What we can do if we have the resources and the community will, is to get those people treated now before they develop infectious TB and prevent both them from getting sick and from them spreading it to others in the future," Duchin said.


But health workers will tell you, we simply don't have the resources to track and treat each case of latent TB. Karen Winchell is a public health nurse in Snohomish County. She works overtime treating people who are actively sick and checking anyone around them.

"We first screen their family, because that's who they're spending the vast majority of their time with," Winchell explained. "And then if we find a number of them have been infected, we would widen that circle for the contact investigation."

Winchell focuses exclusively on TB cases in Snohomish County. There are also outreach workers who help visit patients, making sure they're compliant with taking medications and getting the help they need. Sometimes workers check in via Skype, saving commute time. But they still could use more staffing, if the budget allowed it.

"When I first worked here in TB, we had four public health nurses, all working full time. Now we have two," Winchell said. "It's a challenge to meet the needs."

A skin or blood test can detect those people quietly carrying TB. They don't feel sick.

Treating latent TB can cost as little as $500 per patient. When the disease explodes into an active case, so does the cost, jumping to around $17,000. Health workers also say they're seeing more complex cases that are drug resistant. Those can cost more than $100,000 to treat.

"The inability to treat latent TB is a huge frustration and should be of great concern to all of us," Duchin said. He added that 5 to 10 percent of latent carriers will eventually have active TB. Age and underlying health conditions could make TB active.

To learn more about TB go to this site at the Centers for Disease Control and Prevention.


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