Written by Masa Narita, TB Control Officer,. Public health — Seattle & King County

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As much as a fourth of the world’s population is estimated to be infected by the tuberculosis bacterium. The vast majority are “latent” infections, meaning the bacteria is dormant, or “asleep,” in people’s bodies. But latent TB infection (LBTI) can lead to active tuberculosis: Ten million people developed active TB in 2020, and 1.5 million people died of the disease globally.

On World TB Day, March 24, 2022, it is important to remember that this is not just a problem overseas: in King County, an estimated 100,000 people have LTBI, and there were 104 cases of active TB in 2021. The majority of active TB cases progressed from the LTBI pool, and they could have been prevented.

The number of people diagnosed with active TB in King County has remained relatively steady at around 100 cases per year. In addition to caring for TB patients and those who were exposed to infectious TB, it is crucial to address latent TB infection. Without tackling LTBI, it will be impossible to bring active TB disease case counts in King County down from the current level (45 cases per million people) in King County to the levels needed to eliminate the disease (<1 case per million people).

The status quo leaves far too many people every year dealing with the isolation, complex medical treatment, and potentially serious health outcomes that come with TB disease. Nearly all TB cases could be prevented by testing people at higher risk (particularly those born outside the U.S.) for LTBI and treating them when a diagnosis is made.

That is why Public Health – Seattle & King County is expanding the county’s TB control program to confront latent TB infection, with the goal of decreasing TB disease by 20% in the next 10 years. To achieve this, the TB program is:

• Creating a new Community Prevention Unit in the TB program to do outreach to healthcare agencies/providers and TB affected populations
• Receiving a CDC-sponsored research grant to support work with International Community Health Services, focusing on improving LTBI treatment in primary care settings
• Hosting a CDC LTBI communications campaign in Seattle, aimed at reaching priority populations

Latent TB infection is treatable, and treatment prevents progression to active TB. On this World TB Day, this message is especially important for anyone who was born or lived in a country where TB is common (outside the United States, Canada, western Europe, Australia and New Zealand): talk to your healthcare provider about whether LTBI testing and treatment is right for you.

Originally published 2/24/22