We rarely hear about someone being sick with tuberculosis (TB) – much less dying from it – here in King County. And yet, Public Health has an entire program and clinic dedicated to TB.
In light of King County Board of Health recognizing March 24, 2026, as World Tuberculosis Day, we sat down for a Q&A with Public Health’s Dr. Caitlin Reed, the Medical Officer for Public Health’s TB Program, so we can learn more about this local public health success story.
Q: We don’t hear much about TB in the U.S. So, why does Public Health need a full TB Program?
Dr. Reed: The fact that we don’t hear much about TB here in the U.S. is an example of the success of our public health systems. As they say – when public health is working well, we don’t often hear about it!
In the U.S., and particularly here in King County, we have a strong public health infrastructure that helps prevent TB outbreaks.
About 100 people in King County are diagnosed with active TB disease each year. Public Health’s TB Program acts quickly to connect these patients to medicine that cures their disease. As a result, people very rarely die of TB in King County and we don’t often experience TB outbreaks.
Our public health system also connects people who have latent TB, which could one day develop into active TB disease, with treatment so they don’t get sick and spread it to others. In addition, here in the U.S., we have less crowded housing and better ventilation in housing, meaning TB can’t spread from person to person as easily as it does in some other parts of the world.
In much of the globe, TB is more common and, sadly, the infrastructure is often not in place to connect people with treatment, so people end up dying from TB – a curable and preventable illness.
Q: You direct Public Health’s TB Program. What does this Program do?
Dr. Reed: A lot of things!
Our TB Program at Public Health works hard to care for and support people with active TB disease and their close contacts. We have a TB Clinic that provides people with active TB disease with high quality medical care, visits at home, consults with their other doctors, and referrals to supportive resources.
TB treatment requires taking a course of medicine for a number of months; our caring clinical staff support patients to make sure they can complete their full course of treatment, meaning they are cured from TB. This is also important because not completing the full course of treatment can lead to strains of drug-resistant TB.
We also conduct contact tracing every time someone is diagnosed with active TB disease, which can be contagious. That means we notify people who may have been exposed to TB so they can get testing.
Finally, we educate the public about TB, including community partners who may serve or treat people who are at risk for or have been diagnosed with latent TB. We encourage people who are more likely to have latent TB to get tested so they can get treatment and avoid the risk of their latent TB developing into active disease.
Q: You mentioned latent (or dormant) TB infection. What is it, and why is it a concern?
Dr. Reed: TB can take two different forms:
- Active TB disease, which can be contagious and symptomatic, but is treatable and curable.
- Latent TB infection, which is not contagious and causes no symptoms but can be treated to prevent it from ever becoming active.
Unlike active TB disease, latent TB infection can’t be passed from person-to-person, and people are not ill with the disease. Approximately one in 10 people with latent TB infection will develop active TB disease in their lifetime.
About 100,000 people in King County have latent TB infection. While they aren’t contagious now, they could potentially develop active TB disease in the future, which could be contagious to others. If you were born in or lived in a country with a high rate of TB, talk to your doctor about a TB test to see if you have latent TB. You can get it treated and strongly reduce the risk of developing active TB disease in the future.
Q: As the TB Medical Officer, what is your role?
Dr. Reed: One of my favorite parts of my job is getting to treat patients in our TB Clinic. There’s nothing more gratifying than seeing someone arrive very sick and helping them feel so much better. That kind of success never gets old.
I have particular expertise in drug-resistant TB. It’s rare that we have cases like this locally (usually just 1 to 2 per year), but any time someone in King County is diagnosed with drug-resistant TB, I get involved.
I also oversee research to find better and faster TB treatments. Public Health’s TB Clinic is a study site for two TB clinical trials run by the CDC – the TB Trials Consortium (webpage in English only) and the TB Epidemiologic Studies Consortium (webpage in English only). This means patients at our TB Clinic are offered the opportunity to participate in clinical trials that help shape safer and shorter TB treatment regimens.
Finally, I serve as a resource for local doctors and health departments across Washington state. About half of the state’s active TB cases occur in King County because we have a higher volume of residents who were born in countries with high rates of TB. As a result, many local doctors and most small health departments across the state don’t have much experience in treating TB when they identify a case in their area. Thanks to Foundational Public Health Services (webpage in English only) funding from the state, I’m able to provide technical assistance to these small counties. For example, providing guidance on contact tracing and the right medications in the case of active TB.
Germs like TB don’t obey county lines, so being able to lend my assistance to other health departments means a healthier and safer state overall.
Q: What do you wish people understood about TB?
Dr. Reed: TB is as much about social systems and politics as it is about bacteria. When we invest in public health systems, we can keep TB rates low and ensure TB patients are cured of their disease. When people have access to healthy housing and trust in the medical system, we can prevent TB outbreaks and help support patients in completing their course of medication.
The advancements we have today are easy to lose. As recently as the 1990’s, New York City saw its TB rate double (webpage in English only) following funding cuts to its TB Program, an increase in overcrowding and poverty in its poorest neighborhoods, and the rise of the HIV epidemic. The cost of responding to the TB outbreak in New York City was much higher than the original costs of prevention.
I’m grateful we have such a strong TB Program here in King County and I appreciate the opportunity to educate the public about its importance.
Originally published March 23, 2026.