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SOURCE:  http://seattlepi.nwsource.com/health/355858_tb21.html

100,000 in King County Have Latent TB

By Tom Paulson

Running counter to a nationwide overall decline in tuberculosis rates, TB cases in Seattle and King County have increased and, in 2007, reached a 30-year-record high of 161 active disease cases — three-quarters of them among people born in other countries.

Tuberculosis, a contagious respiratory disease, today infects one of every three people on the planet and can remain dormant for many years before emerging as illness. About 100,000 King County residents have dormant, or latent, TB infection.

“It’s very concerning,” said Dr. Masa Narita, head of TB control for Public Health — Seattle & King County. It is also evidence of the global nature of infectious disease, Narita said, and should serve as a reminder that 2 million people still die from TB every year.

“It is still one of the biggest killers,” he said. In 2006, Seattle and King County officials had reported a 16 percent increase, with 145 active TB cases then.

State public health officials also announced Thursday an overall increase of 11 percent in 2007 in reported TB cases statewide, to a total of 291 new cases, with 55 percent in King County.

“This should be a red flag for everyone, including other states,” said Kim Field, head of TB control for the state Department of Health. Seattle is an international city, Field said, with a large immigrant population and travelers from all corners of the world.

Changes in the TB trends often show up first in port cities with high rates of foreign travel, she said, foreshadowing future increases in other communities. Most of the new cases, 75 percent, are being identified among immigrants from Southeast Asia, Africa, former Soviet states and Latin America, Field said.

“But there is still a significant amount of ongoing cases related to earlier outbreaks among the homeless, especially in King County,” Field said. TB is everywhere, she said, but remains largely neglected when compared with other higher-profile, comparable health threats such as AIDS or malaria.

Dr. Tesfai Gabre-Kidan, an infectious-disease specialist in Seattle who emigrated here from Ethiopia in the 1970s, said TB is a huge problem in developing countries. In Africa, Gabre-Kidan said, the AIDS pandemic has helped to both fuel the spread of tuberculosis while inadvertently obscuring the fact that many reported AIDS deaths are actually TB deaths.

“Here in this country, we used to be very active in attacking the threat of TB,” he said. “But we have now let our guard down.”

Gabre-Kidan acknowledges that many immigrants bring their TB infections with them when they move here. But perhaps the high rates of active disease seen among the local immigrant populations are attributable not so much to this simple arithmetic, he said, as to the fact that so many of them lack access to adequate, preventive health care services.

“I think this could also be a root cause,” Gabre-Kidan said.

In addition to the local increase in TB cases, public health officials are generally concerned about the increasing number of cases of TB that are resistant to treatment. Although only a handful of cases of multidrug-resistant TB (MDR-TB) have been identified in this region, many experts warn that lack of aggressive containment of TB worldwide will lead to a spread of TB strains that are difficult, if not impossible, to treat.

If the moral or community health implications of the ongoing TB problem here is not enough to convince people that this is a serious problem, Narita noted that failure to prevent the spread of this disease will be very costly to taxpayers.

Given the current drugs available to treat TB, Narita explained it can take anywhere from nine months to several years of therapy to clear the infection and cure the disease. Every single patient with routine TB costs about $10,000 to treat, he said, and drug-resistant cases can cost as much as $250,000 dollars per patient.

Harborview Medical Center and the health department already work with area clinics, schools, churches and other organizations to test and then treat people diagnosed with TB.

But Narita said it would require screening a half-million people to try to find all of those with dormant infections and still would be a challenge to identify all infected.

“This is a major health problem for the world,” he said. “And we see it reflected here.”

ABOUT TUBERCULOSIS

TB is an infection that most severely attacks lung tissue and is caused by an airborne class of microbes known as mycobacteria.

When a person with the illness coughs, the bacteria can be inhaled by another person; however, TB is less contagious than the common cold.

One in three people on Earth carries the bacterial infection, and about 10 percent progress to disease. Nearly 2 million people die from TB every year, making it one of the world’s biggest killers.

There are drugs and a vaccine for TB, but none is ideal. Drug treatment of the bacterial infection is cumbersome, time-consuming and expensive. The vaccine is not very effective at preventing the infection.

Public health experts are more concerned than ever about the potential for increased drug-resistant strains of TB worldwide.

A free informational World TB Day forum will be held at 7 p.m. Monday at Town Hall in Seattle.

In much the same way that a bad marriage is not healthy if one partner is in it for what they can get out of it, and the other is co-dependent on that partner. Illegal immigration is unhealthy for the co-dependent country involved.

Almost daily we hear how our crashing economy is causing an exodus of illegals returning to their homelands when the work, money, and handouts runs out. Many of these are represented in the media as hardship stories built to display the “poor undocumented worker”, “poor businesses”, and in some cases “poor community” who are being affected by the loss. While no one can dispute the effect this loss has on those elements, they are in essence, no different then those who are co-dependent marriage partners who suddenly find themselves struggling to learn to survive.

What needs to be understood, and understood firmly, is that illegal immigrants are not here “for better or for worse”. They will not hang around when this country struggles. They will not hang around if the country falls. Their loyalty is not to this country at all and they will return home to the place their loyalty lies, or move on to another country that has what they desire. In this case money, work, and someone to take care of them.

American citizens and many legal immigrants have a deep loyalty to the United States. No matter how hard it gets in the nation, they will hold on, they will struggle through, and they will work to improve the situation of the home they love unconditionally. “For better or for worse” is not even a thought for them, it’s a way of life.

Just as one would not support a loved on, or friend in an unhealthy relationship. America needs to not support this unhealthy relationship that’s been created by illegal immigrants and their advocates. Americans need to support and advocate for healthy relationships with Citizens and legal immigrants who had a deep unseated love for this country. Who will stick with her through thick and thin, no matter how thin it gets. It is that, and that alone that makes for a healthy relationship and a healthy nation.
As for the “woe is me” tales, well just like the co-dependent partner learns to live again. These co-dependent individuals, businesses, and communities will also learn to live again. In many cases they will learn to be stronger, stabler, and healthier then before when they were in the unhealthy relationship. In some cases they might not ever break the bonds of co-dependency but above all they will learn what the signs of co-dependency are and be able to advocate against it, while helping awake other co-dependents to be able to survive the “life without” too.

Hispanic exodus is under way
Workers leave Lee as jobs disappear
The News Press
March 9, 2008

In this case, cold, hard statistics don’t tell the story.

“I am not aware of anyone who would track that locally,” said Glen Solier, business development specialist for the Lee County Department of Economic Development.

“Those people are off the grid. Undocumented,” said Susanna Patterson, economic analyst for the Florida Agency for Workforce Innovation.

But the oh-so-human snapshots of everyday living are revealing.

Like a weekend soccer league down from 32 teams to 25 because more than 100 players have had to leave.

Or a church that has cut two Sunday services to one because about 200 former members have returned to their homeland.

Or the western-wear clothier who gave up one of his three shopping center units and said business is off by 40 percent because customers are gone.

Put these and other pictures together and the collage tells the story of Hispanics who are leaving Southwest Florida to find work or to return to the support of their families back home.

“There is a loss in the number of Hispanics in our communities,” said Robert Selle, director of the Amigos Center, which aids Hispanics with immigration issues and offers other services in Lee County. “The underlying reason is economic; the same reason they came here in the first place.”

Population drain

The loss comes from a good portion of Lee County’s population. The U.S. Census Bureau listed the county’s Hispanic population at more than 90,000 - about 16 percent of Lee’s 571,000 population - in 2006.

What the statistics further show is that work is gone. Unemployment in the Fort Myers-Cape Coral region has risen this past year, from 2.7 percent to 6.3 percent.

Many of the lost jobs are in construction, which has been put on hold as the sluggish market struggles with a glut of unsold houses.

Because many Hispanic construction workers are believed to be illegal immigrants, because construction and agricultural workers are a mobile population anyway, because many are single with families back in their native lands, and because their leaving was often spur-of-the-moment, no governmental or social service agency is keeping accurate records of this exodus.

Lee County School District reported a loss of Hispanics in all grades totaling 388 pupils through January of this school year - this after growing by almost 3,000 Hispanic students a year earlier.

But the white student population dropped as well. The big difference was while dropout rates tend to increase as the year goes on in the upper grades, the Hispanic population was the only one also to lose ground in the kindergarten through fifth-grade range. It fell by 87 pupils - an indication their families moved from the district, according to Michael Smith, director of planning, growth and school capacity.

“Many workers in the construction industry and related industry are leaving the area and following the money,” said Barbara Hartman, spokeswoman for the state’s Career and Service Center in Fort Myers. “It seems to be an increasing number of people who are temporarily relocating. I wish we did track that.”

Hartman said she knows people are leaving because they tell counselors when they come in seeking work, saying they need the higher construction industry wages, which begin at $10 to $11 an hour for the most unskilled, to maintain their standard of living……..

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