Isle TB cases decreased last year, official says
World Tuberculosis Day was expected to be observed today with good and bad news.
Tuberculosis cases in Hawaii decreased 3.4 percent last year -- to 112 active cases from 116 in 2004, reported Dr. Jessie Wing, chief of the state Department of Health's TB Control Program.
The bad news: A strain of extensively drug-resistant tuberculosis that is virtually untreatable, XDR TB, has been identified, primarily in South Korea.
Hawaii has not had any such cases, although Wing fears it could get here at some point. "It's scary because it's not sensitive to the usual TB drugs, first or second line," she said.
She said the state is doing a little better with drug-resistant cases. Eight occurred last year out of a total of 112 TB cases, compared with 12 cases out of 116 total cases in 2004.
One multiple-drug-resistant TB case was reported in 2004, and none last year, she said.
Hawaii is usually one of the states with the highest tuberculosis rates, largely because of an influx of immigrants.
More than 73 percent of the state's TB cases last year were foreign-born, compared with 54 percent foreign-born cases reported nationally in 2004.
Although many people think TB is a disease that has been defeated, it is still a leading killer worldwide among infectious diseases, Wing pointed out.
She said two forms of the disease exist, both curable:
» Latent TB infection, when a person has the bacteria but is not sick because of a protective immune system. Latent TB infection cannot be spread to others.
» Active TB, when an immune system no longer protects someone with TB and they become ill. They can pass it on to other people.
Wing is excited about new-generation diagnostic tests that are becoming available.
Her program has been tracking the new QuantiFERON TB Gold blood test, developed in Australia, because it does a lot of screening, she said.
Last year, the Health Department clinics read more than 50,000 tuberculin skin tests statewide. Of those, 17.8 percent were positive, she said. Most had latent TB infection and were offered nine months of antibiotics to prevent active development of the disease.
The program also has a new method approved by the Food and Drug Administration last year to diagnose the disease, using blood tests instead of skin testing, she said.
Wing said the new blood test is expensive, costing the state about $20 compared with a free skin test, so it is being offered only to high-risk groups following Centers for Disease Control guidelines.