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Hawaii, leader in
TB cases, to launch
screening program

By Helen Altonn
Star-Bulletin

Hawaii is observing World Tuberculosis Day today with plans to start a screening, education and prevention program in communities at high risk for the disease.

The 50th State has had the highest rate of tuberculosis cases in the nation since 1992.

The statistics reflect Hawaii's attraction for international visitors and immigrants, said Dr. Jessie Wing, chief of the state Health Department's Tuberculosis Control Program.

"We have to remain vigilant in our TB testing and aggressive in the medical treatment of cases," she said.

She said the program is updating its policies to develop a model program in TB control and prevention for the state.

The Health Department will receive $114,000 in supplemental funds for five years from the Centers for Disease Control to start a targeted TB screening program, said Gabriel Palumbo, CDC public health adviser in the tuberculosis program.

A public health educator and public health nurse will be hired to run the education and prevention program, he said.

They will focus on communities in Honolulu with high risk for TB infection since most cases occur there, but will also go to communities on the Big Island and Maui, he said.

"It is hard to reduce our incidence rate when the majority of cases is coming in from other countries," he said, pointing out that about 82 percent of TB-infected people in Hawaii are foreign-born.

Hawaii last year had 184 tuberculosis cases -- an incidence rate of 15.5 cases per 100,000 population.

Oahu has the highest number of cases in the state, with 147 last year and an incidence rate of 16.8 cases per 100,000 population.

A trend toward abolishing the disease was reversed when states became complacent and redirected money to other programs in the 1970s and early 1990s, the CDC reported.

A 20 percent increase in cases occurred in the United States between 1985 and 1992. However, a 7 percent decline occurred from 1997 to 1998, the CDC said.

TB continues to be one of the leading causes of death worldwide, killing 2 million to 3 million people annually.

But Hawaii rarely has a death from tuberculosis, Palumbo said. "The advent of antibiotics has reduced the death rate. It's curable."

An airborne disease caused by small bacteria, TB usually affects the lungs but may also damage other parts of the body.

People can become infected when a person with the disease coughs, sneezes or sings. Symptoms include cough, fever, night sweats, loss of appetite and weight, and fatigue.

If people with active TB don't complete treatment for at least six months, they can develop drug-resistant strains that are difficult and expensive to treat, the CDC said. One multidrug-resistant TB case can cost up to $1 million to treat.