Global Disease Settles in North Carolina

Tuberculosis cases in North Carolina rose from 397 cases in 2001 to 436 cases in 2002, health officials said. Wake County had one of the sharpest increases in the state, jumping from 40 cases in 2001 to 57 in 2002. The spike cannot be attributed to a single factor, state and local health officials said, but among the chief causes is an influx of immigrants from regions where TB is rampant, including Asia, Africa and Central and South America.

North Carolina's increase in cases is glaring against the national backdrop, where the rate of TB infections last year hit a historic low. However, ten other states also reported increases.

"We will get to the point where if we want to control TB in the United States, we will have to control TB around the world," said Dr. Jason Stout, Wake County's TB medical director.

Statewide, the number of foreign-born TB patients has almost doubled in five years, from 70 to 134. About a third of new TB cases are among immigrants who contracted the bacteria in their homelands. Most remained free of active infection until after they immigrated.

"We did a study last year, and an average person with TB requires 97 hours of care" during a directly observed drug regimen, said Gibbie Harris, Wake County's director of community health. "When you throw in homelessness or loss of income, language barriers or HIV, it raises that to 477 hours."

One troubling aspect of North Carolina's higher TB count is the number of children infected, said Dr. Carol Dukes Hamilton, medical director of the state TB control program. Of last year's cases, 32 were children younger than 14. "An adult could have been infected years ago, but that's not true in children," she said. Whether the state's TB increase last year signals a trend or mere blip, "We'll have to wait and see," Hamilton said. Even with an occasional one-year uptick, the state's TB rates have dropped steadily for 20 years.

Back to other news for July 18, 2003