TB Cases in County Are Up 21%

A 21% rise in Orange County tuberculosis cases is raising concern among some health officials who say the increase runs counter to a nationwide decline.

The latest data show that the number of reported tuberculosis cases in Orange County jumped from 273 in 1996 to 330 last year. The number of cases nationally fell 7% during that time.

The sudden spurt in local cases was particularly surprising after a steady drop over the last three years.

Officials attributed the increase to two major factors: immigration trends and improved county measures to diagnose and report cases. And they noted that the figures are still far lower than the high of 430 reported in 1993.

“It’s not that we have a precipitous disease,” said Penny Weismuller, county manager of disease control. “It’s partly because we’ve worked more aggressively to diagnose and report the cases.”

Last year, the county hired a public health nurse to routinely survey hospitals and doctors’ offices to tally the new cases. Patients found to be infected with or carrying the disease were treated and monitored over time. Their family members and co-workers also were interviewed and screened. This helped yield other diagnoses, Weismuller said.

Other efforts to help identify cases included distributing to college health offices a manual on how to deal with the disease. Student brochures on local tuberculosis testing sites and common symptoms also were distributed.

Another factor contributing to the increase is immigration patterns. Some immigrants come from countries such as Vietnam and Mexico where the tuberculosis rate is high, Weismuller said.

It’s not that immigration from these nations suddenly increased last year, she said, but that the county has been working more closely in the immigrant communities to identify cases.

States with large immigrant populations tend to have higher tuberculosis cases. Nationwide, about a third of the cases are among those born abroad. In Orange County, that number is nearly 87%.

More than 58% of those identified with tuberculosis last year were Asian and nearly 31% were Latino. About 11% were white.

The local statistics, officials said, signify a demand for more educational and testing programs in various communities. Early diagnosis is key in controlling the disease, they added.

“Tuberculosis is an insidious disease because it cannot be easily recognized,” said Pearl Jemison-Smith, a former nurse who helped found the Tuberculosis Coalition, a nonprofit group that provides outreach programs countywide. “We’re working to alert physicians to look for classic signs of TB.”

Tuberculosis can be contracted through prolonged exposure. It also is a curable through medication.

Common symptoms include a bad cough lasting for more than two weeks, chest pain, weight loss, fatigue and coughing up blood--a sign of advanced development of the disease.

So far this year, 68 tuberculosis cases have been reported, down from the 78 reported at this time in 1997, health officials said.

For more information on tuberculosis, contact the Orange County Health Care, Pulmonary Disease Services Clinic at (714) 834-8796.

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More TB in O.C.

Tuberculosis cases increased 21% last year in Orange County, where the problem is most heavily concentrated in the Asian community.

1997: 330

1997 Cases

Asian: 58%

Latino: 31

White: 11

Source: American Lung Assn. of Orange County; Researched by TINA NGUYEN / Los Angeles Times