NewsDesk @bactiman63

Washington state health officials are on heightened alert as cases of tuberculosis (TB) are on the rise.

TB reporting decreased in 2020 during the first year of the pandemic. Though efforts to prevent COVID-19 may also reduce the spread of TB, the decrease could also have been due to delayed or missed TB diagnoses because of strains in the health care system. Some people with TB may also have been misdiagnosed as having COVID-19.

Scanning electron micrograph of Mycobacterium tuberculosis, the bacteria that cause tuberculosis. NIAID

Cases then rose notably beginning in 2021, when 199 cases of TB disease were reported, a 22% increase from 2020. Thus far in 2022, 70 cases have been reported and officials continue to monitor the situation closely. Seventeen new cases of TB disease all have connections with each other and several Washington state prisons, making it the state’s largest outbreak in the last 20 years.

“It’s been 20 years since we saw a cluster of TB cases like this,” says 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,” added Kwan-Gett. “Increased access to TB testing and treatment in the community is going to be key to getting TB under control.”

“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 DOC Chief Medical Officer MaryAnn Curl, MD. “Testing of staff, and our incarcerated population at Stafford Creek Correction Center continues, which is how these cases were found. We’ll continue to communicate with staff, their incarcerated population and their families as appropriate.”

According to the Centers for Disease Control and Prevention (CDC), Tuberculosis is caused by a bacterium called Mycobacterium tuberculosis. The bacteria usually attack the lungs, but TB bacteria can attack any part of the body such as the kidney, spine, and brain. If not treated properly, TB disease can be fatal.

TB is spread through the air from one person to another. The TB bacteria are put into the air when a person with TB disease of the lungs or throat coughs, sneezes, speaks, or sings. People nearby may breathe in these bacteria and become infected.

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Symptoms of TB disease can include coughing, with or without blood, and chest pain. General symptoms also include fever, night sweats, weight loss and tiredness.

If infection does occur the person exposed will most likely develop inactive TB or (also called latent TB infection), which does not have any symptoms and is not contagious. But if people with inactive TB do not receive timely diagnosis and treatment, the infection could develop into active TB disease which can then cause symptoms and be spread to others. An estimated 200,000 people in Washington have inactive TB.

Treatment for TB disease takes six months at a minimum. If treatment isn’t diligently followed, symptoms are likely to become more severe and patients risk continuing to be contagious, increasing the likelihood of TB further spreading within the community. Incomplete treatment can also contribute to the spread of antibiotic resistant strains of TB.