Case-detection efforts spot 122 isle TB cases
The figure for last year is a 7 percent increase over 2006 numbers
Tuberculosis cases in Hawaii increased 7 percent last year over 2006, with TB control investigators checking out hundreds of people on ships and in schools.
"It was a very busy year," said Dr. Jessie Wing, chief of the state Department of Health's TB Control Program and U.S. Centers for Disease Control and Prevention medical officer. "We had a number of large investigations. It shows our surveillance and case detection is working."
The state's TB case rate climbed to 122 cases, or 9.5 per 100,000 last year, from 114 cases, or 8.9 per 100,000 population in 2006.
Despite the annual increase, however, TB rates have declined 37.5 percent in Hawaii since 1997 when there were 15.2 cases per 100,000 population.
Nationally, the TB case rate fell last year to a record low of 4.4 cases per 100,000 population. But the CDC reports annual declines in national rates have slowed from an average drop of 7.3 percent from 1993-2000 to average 3.8 percent declines in rates for 2000-2007.
One multidrug-resistant case was reported in Hawaii last year, Wing said. No "extensively drug-resistant" cases have been detected here, but they have been reported in other parts of the world. South Africa is trying to contain such an epidemic.
Hawaii has one of the highest TB rates in the country because of a large immigrant population, with foreign-born residents accounting for 63.9 percent of all local cases.
Of the new cases, Honolulu had 109, Maui had 8, the Big Island had 5 and Kauai had none.
Hispanics accounted for more TB cases nationally than any other racial or ethnic group. Hawaii had only one Hispanic case last year, but the TB rate for native Hawaiians and Pacific Islanders was more than nine times higher than for whites, the TB Control Program reported.
Wing said her staff worked around the clock in some cases, screening hundreds of people for TB on ships and in several schools.
They found three active TB cases on two ships and one student and one teacher infected in two schools. No secondary cases were found in the schools, Wing said. "There is probably little to no transmission in schools. That's good."
She said some Asian countries have changed their TB screening procedures. "They're trying to work up potential TB cases overseas and keep them there and treat them before they come here.
"It's a double-edged sword," she said. "It's a good thing to diagnose and treat overseas, but it depends on their resources. We hope these countries have funds for medicine."
If people with active TB have not been treated adequately when they arrive here, she said, it could induce drug resistance and would be much more difficult to treat them.
She said the staff has been trained and updated with the latest CDC guidelines, and "we're looking for cases."
The program purchased a mobile X-ray unit and is waiting for a digital upgrade scanner to take it into the field, Wing said. "We have one of the busiest digital X-ray systems in the state," she said, with 13,000 X-rays annually.
"It has taken a beating. We're trying to upgrade it before summer," she said, noting this must be done on savings because the program has no new funding. "It's a little challenging."
WHAT IS TB?
Tuberculosis is a curable disease caused by bacteria. It is spread easily through the air from one person to another -- when someone with the disease coughs, sneezes, speaks or sings. It commonly affects the lungs but can damage other parts of the body and cause serious illness.
Latent TB infection is when a person has the germ that causes TB but does not have the disease because of a strong immune system. These people are not sick or contagious, but medicine is advised to prevent the disease from developing.
Active TB disease is when a person's immune system is no longer protective and active TB germs enter the body or inactive TB germs become active. The person becomes sick and is able to give others the infection.
General symptoms include a prolonged cough, weight loss, fevers, sweating at night, feeling weak or tired, a bad cough that lasts longer than two weeks, chest pain or spitting up blood.
The state Health Department's Lanakila Health Center is offering free screening April 7-13, during Public Health Week, for people at high risk for TB (those with diabetes, HIV/AIDS and who travel from countries with high TB rates). The center is at 1700 Lanakila Ave.
For more information, call 832-5731 or the information line, 832-5738.
Source: Hawaii State Department of Health Tuberculosis Control Program
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