Tuberculosis cases dropped nationally in 1996, but they were up by nearly 21 percent in Utah last year, according to statistics released by the federal Centers for Disease Control in Atlanta.
CDC Director David Satcher said the disease went down nationally for the fourth straight year, suggesting the United States has recovered from the TB resurgence that began early last decade.But he warned against complacency, saying the nation let its guard down in the 1980s "and TB came back in a form more deadly than before."
"Now that we're back on the track toward eliminating TB in this country, we need to finish the job," Satcher said in written comments.
The Utah increase partly results from nothing more alarming than the statistical fluctuations that are normal with a small population base and a relatively rare disease: Only 58 Utahns were reported with TB in '96.
And many of those who were diagnosed were migrant workers from other states or countries.
In addition, Utah ranks 37th in the country in the rate of TB, which is caused by bacteria. Utah's rate of 2.9 cases per 100,000 population is far better than the national average, which is around 5.5.
But the rate is still a worry to health administrators.
"The high number of cases that we saw in '96 was a real concern to us," said Charles Brokopp, director of epidemiology and laboratory services for the Utah Health Department. "There was an increase in the amount of tuberculosis associated with non-Utah residents that was picked up here in the state."
According to Brokopp, homeless people and new arrivals from outside the country and outside the state were the two categories where TB increased. A silver lining was that "we did not see an increase in tuberculosis associated with people with HIV infection."
In the past, people whose immune systems are weakened by AIDS, caused by HIV, were more likely to get tuberculosis and other infectious diseases.
CDC figures show Utah's TB cases have bounced around for the past few years:
- In 1993, the state reported 46 cases. The following year, there were 55, an increase of nearly 20 percent.
- In 1995, the number dropped to 48, meaning it was down by almost 13 percent from the 1994 figures.
- In '96, it was back up to 58, an increase of nearly 21 percent over the 1995 report.
So is the trend continuing up? "No, it is not," Brokopp said. "In fact, for '97 the reported cases for tuberculosis are significantly less than what we saw in '96."
Official CDC reports show only one case of TB in Utah for this year to date, although he said that report must be several weeks old, as more have been reported.
"During the first quarter of any calendar year the reported cases of tuberculosis are low." Then they go up in the late spring and early summer, when an influx of migrant workers comes into the state.
The higher level of TB in 1996 "is a reminder to us that tuberculosis has not gone away. During the mid-1980s, we were talking about eliminating tuberculosis, but due in part to the increase in tuberculosis that we've seen throughout the country that's associated with HIV infection, and the increase in drug-resistant tuberculosis, it has not allowed us to eliminate tuberculosis."
Utahns need to be concerned about TB, he said. "We have seen drug-resistant cases of tuberculosis in Utah. Some of the organisms are not only resistant to one of the medications but as many as three or four of the common-used drugs."
However, a cocktail of several antibiotics usually can wipe out any case of the disease, he said.