Health officials are monitoring 15 active cases of tuberculosis in the Lower Yakima Valley, which is down a bit from earlier this spring.
Of those active TB cases, Indian Health Services and Yakama Tribal Health are monitoring nine and the Yakima Health District is monitoring six, health district spokesperson Stephanie Ruiz said in an email.
County health officials reported 17 active TB cases during the health district's April 30 board of health meeting. That came after the health district first reported "a significant increase" in active TB cases in late March in the Lower Yakima Valley, including areas within the Yakama Reservation.
Yakima County had nine cases in 2024, two in 2023 and five in 2022, according to state health data.
Tuberculosis is caused by an airborne bacterium and primarily affects the lungs, but can also spread to other parts of the body, according to the health district. Not all who are infected with TB bacteria become sick. Active TB is contagious and causes symptoms. It can be life-threatening if not properly treated.
The risk to the general public remains low. Most people don't need to take extra precautions unless they have been identified as a close contact.
How it spreads
The bacteria are spread through the air when an infected person coughs, sneezes or speaks. Tuberculosis is primarily spread through prolonged, close contact with an infected person in an enclosed setting, Ruiz said in her email. For a healthy person, that could be several hours a day, every day, for several months. Children and those with weakened immune systems are at greater risk.
"You have to have a very prolonged exposure," Melissa Sixberry, the director of disease control for the health district, said during the April 30 board meeting.
Treatment with antibiotics can take several months. Patients must follow treatment completely and exactly as directed or risk the possibility of the disease returning in a drug-resistant strain.
Dr. Neil Barg, health officer for the health district, said public health workers help people follow through with treatment, which is crucial.
"Because the treatment can go for as long as nine months, you need infrastructure to help. If they stop prematurely, the disease is not eradicated and more spread can occur," he said.
About the disease
People with inactive TB, also called latent TB infection, have the bacteria in their body but have no symptoms and aren't contagious. Latent TB can turn into active TB at any time, with those who have a weakened immune system at higher risk.
Barg noted that over the last 30 years there had been an overall decline in the number of cases worldwide.
"But since 2020, cases have increased, predominately among sub-Saharan Africa and southeast Asia," he added. "The disease is much worse in poorly resourced countries. One way to combat that is to supply treatment to the people who become infected. ... If the drugs are made available, you can greatly decrease the number of cases."
Tuberculosis is the deadliest infectious disease worldwide, according to a Washington State Department of Health summary brief of 2024 cases in the state.
In 2024, 257 cases of active TB were recorded in Washington. It's a 17.4% increase from 2023 and the highest case count since 2007, according to Washington State Department of Health statistics.
Collaboration is key
Indian Health Services, Yakama Tribal Health and the Yakima Health District have been collaborating to address the increase in cases in the Lower Yakima Valley.
The work includes identifying potential exposures, notifying and testing anyone who may have been in close contact with someone diagnosed with active TB, officials have said.
"One of the things that our TB people do is when there is an outbreak and they identify an active case, they interview those patients with active TB to find out exposures," Barg said. "The rate of conversion to active TB goes way down once they're treated for latent TB. Public health infrastructure is important in tracking and preventing future outbreaks."
Some health board members asked about TB testing in the community. Nursing homes and long-term care facilities have their own routine TB testing protocols, among other organizations. There are no changes or expansions to those routine protocols in nursing homes or long-term care facilities at this time, Ruiz said.
The vaccine for tuberculosis isn't typically given in the U.S. because the disease isn't prevalent, according to the Centers for Disease Control and Prevention. The Bacille Calmette-Guérin vaccine is given to infants and small children in countries where the disease is common.
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