Tuberculosis on the rise in the Washington DC area

Kate Randall
22 March 2001

The rate of tuberculosis infection is increasing in the Washington DC area, according to figures for the year 2000 from the US Centers for Disease Control. The number of TB cases in Washington rose by 21 percent over 1999 rates and in Northern Virginia the number was up 5 percent.

These figures are indicative of the further growth of social inequality in the DC area. Washington is home to some of the most wealthy politicians, media figures and their hangers-on. Corporate sponsors doled out more than $40 million to pay for the inaugural festivities for George W. Bush last January. But only blocks from the White House and the Capitol are some of the most devastated neighborhoods in the country, where working class and poor residents face record levels of poverty, infant mortality and HIV infection. Added to this now is an increase of tuberculosis, a disease which has been on the decline in most parts of the United States for decades.

Tuberculosis is a bacterial disease that attacks the lungs. It is the top infectious disease in the world and has been on the rise worldwide in recent years. In the US, however, rates of infection have been steadily dropping since the 1950s. TB cases were down 6.6 percent last year from 1999. But among newly arrived immigrants the disease has been on the increase. The growth of TB cases in the DC area has been attributed to the influx of immigrants in recent years from African, Southeast Asian and Latin American countries.

Venkatarama Koppaka Rao, director of the tuberculosis control division at the Virginia Department of Health, commented, “TB has always been a disease of the disenfranchised.” Rao was speaking Tuesday at a TB conference in Fairfax County in Northern Virginia. “People living in poverty are often forced to live in close quarters,” he said, facilitating transmission of the bacteria that carries the disease.

Across Virginia, there were 292 active cases of tuberculosis reported last year, a 12.6 percent drop from 1999, the lowest ever recorded number. However in Northern Virginia counties there were 149 reported cases, more than half the state's total, and 89 of these were in Fairfax County. Foreign-born residents accounted for 92 percent of the county's total number of cases. While the county's population has increased in this same period, the rate of TB infection has surpassed that growth. In Washington DC there were 85 reported cases of TB last year, up from 70 in 1999.

Health officials attribute some of the increase to undocumented immigrants entering the area, who undergo no health checks. However, the TB screening of legal immigrants may itself be inadequate because it usually does not detect inactive TB bacteria. One third of the world's population, or about 1.7 billion people, are carriers of the bacteria that causes TB, but only a very small fraction of these individuals develop active tuberculosis.