Tuberculosis Cases Up 9 Percent

* The vast majority of tuberculosis cases in Massachusetts are among people born in other countries.

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BOSTON – The number of active tuberculosis cases reported in Massachusetts rose 9 percent last year, but public health officials said they aren’t alarmed by the rise and consider the disease under control.

The number of cases of the pulmonary disease rose to 284 in 2004 from 261 cases in 2003, according to information released yesterday by the Department of Public Health. The rise, which came after years of decreasing or stable caseloads, is largely due to latent infections that recently developed into active cases, according to the DPH.

The vast majority of tuberculosis cases in the state are among people born in other countries which have a high prevalence of the disease. The disease is also found among the homeless or people who have compromised immune systems from AIDS. The development of symptoms can occur years, or even decades, after infection, according to Dr. Alfred DeMaria, the chief medical officer for DPH.

The uptick was the largest in the state since a 10 percent rise in 1988. DeMaria called the increase “worrisome,” but not cause for alarm.

“We’re always concerned if the numbers are going in the wrong direction,” he said.

DeMaria said public health officials need to boost testing and prevention efforts.

“If we’re really going to get the cases down, we have to do more than just find active TB and treat it,” he said.

Tuberculosis is a bacterial disease that usually attacks the lungs. It’s spread through the air when an infected person coughs or sneezes. Tuberculosis kills more than two million people each year, making it the world’s second leading killer of adults.

Susan Etkind, director of DPH’s Division of Tuberculosis Prevention and Control, said there’s no easy explanation for why the number of state cases jumped last year.

“We have looked at the data every way you can possibly analyze it,” she said. “There’s not one single thing that stands out as being the potential factor that caused the increase for this past year.”

Today, 4.4 people per 100,000 Massachusetts residents have active cases of the disease, compared to 4.9 cases per 100,000 people nationally, according to DPH. As many as 600,000 people in the state may have latent tuberculosis.

Massachusetts is one of 18 states, including neighboring New Hampshire and Rhode Island, which saw increases in 2004.

Massachusetts has had a long history of fighting tuberculosis, which was responsible for one in three deaths in the state in the mid-1800s.