TB evaluation at Harborview Medical Center

A patient at Harborview Medical Center (HMC) in Seattle was recently diagnosed with active tuberculosis (TB). The patient potentially came into contact with other patients and staff on three different occasions between mid-December and January 20. Public Health – Seattle & King County has been notified, and is providing guidance to HMC as they identify and screen exposed individuals.

An X-ray of the chest of a man with tuberculosis. The areas infected with TB bacteria are colored red. Science Photo Library/Corbis
An X-ray of the chest of a person with tuberculosis. The areas infected with TB bacteria are colored red. Science Photo Library/Corbis (via NPR)

TB is not easy to spread

TB is an infectious disease caused by bacteria that are passed from person to person through the air. TB is not easily spread; it’s much harder to spread than the cold or flu. It typically takes repeated and prolonged exposure in a confined indoor space to become infected with TB. Even in households with a contagious TB case, only about 1-in-3 close household contacts become infected.

Details on the evaluation

As a precaution, approximately 45 patients who may have been exposed to the patient with TB are being contacted by HMC, and staff who may have been exposed are being contacted as well. Exposed individuals will be screened by Harborview to determine if anyone has symptoms of active TB, as well as get TB testing to determine if they are infected with TB, but without symptoms (also called latent TB).

Active vs. latent TB

Unlike active TB disease, people with latent (or dormant) TB infection can’t spread it to others and are not ill with the disease. Approximately 100,000 people in King County have latent TB infection. While they aren’t contagious now, they could potentially have active TB in the future and also infect others. Approximately one in 10 people with latent TB infection will develop active TB in their lifetime.

Treatment for TB

The patient at HMC with active TB disease is receiving treatment, and is currently not a risk for infecting others. Most cases of active TB are readily treatable with antibiotics that are commonly available; treatment typically takes six to nine months. Drug-resistant strains require different antibiotics and may include a longer course of treatment (up to two years).

To become cured, a patient must complete the entire treatment, even after they are no longer infectious. If the treatment is interrupted before the bacteria are completely eliminated, TB can develop drug-resistance and become much harder to treat.

People at HMC who are identified to be infected with latent TB may be recommended for treatment, so that they do not develop the disease in the future.

More about TB

TB usually affects the lungs, but can affect lymph nodes, bones, joints, and other parts of the body. A person with active TB in the lungs can spread the disease by coughing or sneezing. In King County, 98 new cases of TB disease were reported in 2015. On average, two cases of TB disease are diagnosed in King County each week.

To learn more about signs, symptoms, and transmission of TB, visit the Centers for Disease Control and Prevention’s TB website.

TB program protects the community

Public Health – Seattle & King County’s TB Control Program ensures that people with active TB are diagnosed and cured, and that others in contact with them who are at highest risk of infection are screened, so that infections do not spread.  This essential public health work improves the community’s health and saves money by controlling the spread of TB, preventing outbreaks, and preventing the development of multi-drug resistant TB that can be very expensive to treat.

TB is a global threat, with over two million deaths every year, as people in many parts of the world do not have access to treatment and effective TB control programs like we do in the United States. Because we are at a global crossroads in King County, we need to be constantly vigilant to prevent the spread of TB.

Originally posted on January 26, 2017