Tuberculosis cases THE NUMBER OF tuberculosis cases in Hawaii dropped by 26 percent last year, but the state still has the second-highest rate of TB cases per capita in the nation.
in isles declined
26% last year
Hawaii still has the second-
highest rate of TB cases
in the nationBy Helen Altonn
Star-BulletinA total of 136 cases were reported for the state last year, compared with 184 in 1999.
Dr. Jessie Wing, chief of the state Health Department's Tuberculosis Control Program, said it is hard to say what caused Hawaii's big dip in TB when total cases nationally declined just 7 percent.
"We like to say it's because of our TB control efforts. We're all trying to do a better job, to be as complete as we can be," she said. "But we need to see if it's just one year or if it's related to immigration."
Hawaii is one of only six states with a significant drop in cases last year, according to the federal Centers for Disease Control and Prevention.
Since 1992, Hawaii has reported one of the highest proportions of TB cases in the nation among immigrant residents. Last year, 81 percent of the state's TB cases were foreign-born, compared to the national rate of 46 percent.
Wing said TB is an old disease, but it is "still very active in Hawaii because we are a gateway to Asia and the Pacific."
TB is an airborne disease caused by small bacteria. It primarily affects the lungs but also may damage other parts of the body. People can become infected when someone with the disease coughs, sneezes or sings. Symptoms include cough, fever, night sweats, loss of appetite, weight loss and fatigue.Tuberculosis is the second-leading infectious killer disease in the world, with 2 million TB-related deaths annually.
News of the decline comes just before World Tuberculosis Day on Saturday -- an annual observance that marks the day Robert Koch announced the discovery of the TB bacillus in 1882.
The day is an occasion to inform the public about the disease and to stress the importance of halting its spread.
THE WORLD HEALTH Organization reports that the epidemic is growing worldwide and becoming more dangerous because of a breakdown in health services, the spread of HIV/AIDS, and drug-resistant tuberculosis strains.
Wing said the Tuberculosis Control Program is "trying to stay ahead of the curve with new TB treatment guidelines and programs to improve TB control" in Hawaii.
The big push now, she said, is to screen and treat latent TB infection with vaccines before it progresses into the disease. She noted that the CDC recently awarded the Hawaii program $110,000 for five years to develop a Targeted Testing Program.
A nurse and health educator will go into communities to work with high-risk populations, she said, including the homeless, immigrants, people with substance abuse problems and HIV, and others who are immune-compromised.
Wing said the team will try to make people understand the seriousness of TB if it is not treated.
Those who do not complete treatment for at least six months can develop and spread strains of TB that are drug-resistant. Treating one drug-resistant case can cost up to $1 million, according to the CDC.
All TB services in Hawaii are free, Wing pointed out, including skin tests, X-rays and drug treatment.