Fewer TB cases in King County could be due to a decline in testing, not infections

In a typical year, 1.5 million people die of tuberculosis (TB) globally and 10 million fall ill with it. In Washington, 7% of people with active TB die. TB has been infecting and killing humans for thousands of years, and in fact, it is still one of the top ten causes of death worldwide. Locally, about 100 people are diagnosed with infectious TB every year in King County.

Public Health officials are concerned about impacts on TB control in the wake of COVID-19. For many years, TB case counts had trended lower over time. However, in 2019, Public Health’s TB Program saw a 43% increase in individuals diagnosed with active TB as compared to 2018. There wasn’t a clear driver behind this increase.  Going into 2020, the TB Control Program expected to see similarly high levels of TB cases, However, in 2020, TB case counts dropped by 31% from 2019.

Potential reasons for the drop in cases:

Public Health’s concern is that due to the COVID pandemic, fewer people are seeking care for and being tested for TB. In fact, findings from a local a survey conducted locally among TB patients diagnosed throughout the COVID pandemic indicated that some patients delayed seeking care due to COVID-19 concerns and/or had their TB diagnosis delayed.

Delayed diagnosis can result in more severe disease and higher rates of transmission. Given this, Public Health is concerned that there are undiagnosed cases of active TB in our  community.  “It is crucial to test for and detect TB early in a person’s infection, maintain case management of infectious TB patients, and provide other important services and interventions to stop the spread of TB,” said King County TB Control Officer Dr. Masa Narita. “Without that, the gains made on a debilitating and deadly disease will be eroded.”

On this World TB Day, March 24, Public Health urges the community to remember that TB is still a concern, and that people should seek care if they have symptoms consistent with TB. Such symptoms include:

  • Coughing that lasts three or more weeks
  • Coughing up blood
  • Night sweats
  • Chest pain, or pain with breathing or coughing

Unintentional weight loss, fatigue, fever, and chills are also symptoms of TB. If you experience any of these symptoms, contact your healthcare provider and ask about TB.

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Originally posted March 24th, 2021