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Following a national trend, the number of tuberculosis cases in Davis County is on the increase, mainly among immigrants coming into the county from parts of the world with high infection rates.

The county used to average one or two cases a year but in 1994 had six active cases, according to Joyce Cole, a nurse who runs the TB treatment program for the county health department.The county administered 2,057 TB skin tests last year and came up with 60 persons who tested positive, indicating an exposure to the disease, Cole said.

Cole said the county usually has between 25 and 35 persons who have been exposed to TB on prophylactic, or preventative, medication at any one time. Currently, there are 19 being treated prophylactically, she said, seven of which are migrant children.

Several of those are almost done with their six-month course of medication, Cole reported to the county health board, but another 20 will be put on the prevention program by the end of the month. Seven of those are migrant adults, she said.

With most patients being migrants or immigrants, problems crop up, Cole said. There can be a language barrier and difficulty monitoring a patient.

Active cases are usually only infectious for the first couple of weeks they are on medication, Cole said, but it takes several months of treatment to defeat the disease.

Of the six active cases in 1994, Cole said, two are children and one patient is known to have exposed 14 other persons. So far in 1995, the county has only one adult that is possibly a new active case, she said.

Because TB is a public health threat, there are legal remedies the county can fall back on for treatment, Cole said, ranging from quarantine to hospitalization, but they can be expensive and difficult to enforce, she said.

"When a person has a communicable disease, you have to balance the rights of the public against their personal rights," said Jerry Hess, the deputy Davis County attorney who advises the health department.

"We first try to get them to cooperate, to stay isolated and to stay on their medication. The problem comes when a person isn't capable of, or refuses to take their medication," Hess said.

While some patients are not as cooperative as the county would like, Hess said, he has not been forced to take legal action against anyone.

That would involve going to court and ask that they be hospitalized or, at worst, detained, Hess said. Both are expensive, he said, especially because the county jail is not equipped to hold a TB-infected inmate.

Cole said anyone reacting positive to the TB skin test, along with active cases, are reported to the state health department. Monthly follow-up reports are also made, Cole said.

The county follows guidelines issued by the National Center for Disease Control in screening and treating for TB, according to Cole.

"We find positive reactors through public screening in our clinics, new students coming in from out of state, new school personnel, day care and health care providers and people entering the county from high-risk areas," according to Cole.