Tuberculosis cases on the rise in Washington state

As of April 28, 70 TB cases have been reported, and 17 new cases have connections with each other.

Across the globe and across Washington state, tuberculosis (TB) cases are on the rise, according to the Department of Health. During the first year of the COVID-19 pandemic, in 2020, TB reporting decreased.

Efforts to prevent COVID-19 may also reduce the spread of TB, however the decrease in reporting TB may have been due to delayed or missed diagnoses because of health care system strains, and some may have been misdiagnosed as having COVID-19, according to the DOH.

“It’s been 20 years since we saw a cluster of TB cases like this,” said Tao Sheng Kwan-Gett, MD, MPH, Washington State Chief Science Officer. “The pandemic has likely contributed to the rise in cases and the outbreak in at least one correctional facility.”

At the beginning of 2021, TB cases rose notably, with 199 TB cases reported, creating a 22% increase from the previous year. As of April 28, 2022, 70 TB cases have been reported to state health officials, and 17 new TB cases have connections with each other—and several Washington state prisons—making it the state’s largest TB outbreak in the past 20 years.

“Washington State Department of Corrections (DOC) identified a rise in cases in one of our facilities and immediately began working closely with the Department of Health and the Centers for Disease Control on testing, as well as ways to decrease the spread in the facility and out in the community,” said MaryAnn Curl, MD, DOC Chief Medical Officer.

Curl relayed how testing of staff and the incarcerated population at Stafford Creek Correction Center, located in Aberdeen, will continue, and was how these TB cases were found. Curl acknowledged how DOC will continue to communicate with staff, the incarcerated population, and their families.

Facts about tuberculosis

Tuberculosis is spread in the air when an infected person coughs or sneezes, and the organism is breathed in by others. The DOH states that prolonged exposure to someone with TB is generally necessary for an infection to occur.

Symptoms of TB include coughing with or without blood, chest pain, fever, night sweats, weight loss, and tiredness. According to the DOH, if an infection occurs, the person exposed will most likely develop ‘inactive TB,’ or ‘latent TB.’ An inactive TB infection shows no symptoms and is not contagious.

If individuals with inactive TB do not receive a timely diagnosis or treatment, the infection could develop into ‘active TB,’ which causes symptoms and can be spread to others. The DOH estimates that 200,000 people in Washington state have an inactive TB infection.

Treatment for tuberculosis takes at least six months, and if treatment is not diligently followed, symptoms of TB are likely to become more severe, and patients risk continuing to be contagious, increasing the likelihood of TB further spreading within communities. Incomplete TB treatment also contributes to the spread of antibiotic resistant TB strains, according to the DOH.

Those who are at increased risk of contracting a TB infection include:

  • Individuals in close contact with someone who has TB
  • Individuals who are from, or frequently travel to areas of the world where TB is common
  • Individuals who live or work in settings where there is greater exposure to TB, such as homeless shelters, correctional facilities, and nursing homes.

The DOH encourages individuals who are at risk to get tested, and if an outcome is positive, to receive treatment.