TB Still on Rise in North Virginia; Drug Resistance, Immigration Cited in Disease's Spread

Bucking the national trend, figures released today by the Virginia Department of Health show that the number of new TB cases increased nearly 5 percent statewide from 2000 to 2001, with 57 percent -- 174 of 306 cases -- occurring in Northern Virginia.

That represents a one-year jump of 17 percent in the region, on top of a 5 percent rise the year before. Reports from Prince William County, which recorded an increase of 188 percent with 26 new cases in 2001, and continuing high numbers from Fairfax County boosted the latest tally. Consistent with the national trend, Maryland health officials reported 262 cases for 2001, a 7 percent decline from the previous year. More comprehensive figures for the District of Columbia and Maryland will be released later this week.

Health officials say the rise of TB is largely a consequence of the migration of people from parts of the world where the disease is common. It is thought that two-thirds of TB cases brought into the United States originate from three countries: Mexico, the Philippines and Vietnam.

The problem is exacerbated because in the United States underinsured patients often balk at the cost of treatment -- prescription co-payments as high as $100 a month for the six to nine months duration -- and stop taking the drugs prematurely, increasing their susceptibility to multi-drug resistant TB. As a result, more dangerous permutations of TB are also on the rise, health statisticians say. Virginia is one of two states (the other is Washington) that do not automatically provide free medication to anyone with TB. Officials in Richmond, however, said that in practice drug costs are fully covered for the indigent, and in cases where private insurers do not cover costs, the state uses a sliding scale to adjust the drug's price. In 2001, there were ten new reports of multi-drug resistant TB in Virginia, up from seven cases in 2000 and four in 1999. Six of the new cases were in Fairfax County.

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