Health protection

How is King County doing?

Current and emerging threats to the public's health include global spread of emerging infections such as West Nile virus and pandemic influenza and ongoing infections such as HIV and tuberculosis; food-borne infections acquired in restaurants; bioterrorism; vaccine-preventable disease; and natural disasters.

• In 2008, 5,028 communicable disease reports among King County residents were received (not including HIV, tuberculosis and sexually transmitted diseases, which are counted separately). Vaccine-preventable diseases accounted for 20 percent of cases, while enteric infections accounted for 16 percent. Of the remainder, more than one-third were reports of chronic hepatitis C virus infection, and approximately one-fifth were animal bites and potential rabies exposures. Reports of animal bites and possible rabies exposures have increased steadily since they became notifiable conditions in 2003.
• Public Health also responds to outbreaks and potential spread of emerging infections. For instance, responding to recent concerns about swine flu, Public Health has actively worked with hospitals and health care providers to promptly identify and investigate potential cases of swine flu and to assure that, if cases are identified, appropriate treatment and measures to prevent transmission to others are used.
• The number of new HIV diagnoses declined slightly from about 350 per year between 1997 and 2004 to about 330 per year 2005 to 2007.The estimated rate of new diagnoses reached 17.6 per 100,000 in 2007.
• In 2008, King County reported 121 cases of active tuberculosis, with increases among Hispanics but decreases among blacks and Asians. King County had a TB rate of 6.5 cases per every 100,000 individuals; this rate remains higher than the national rate (4.2 per 100,000 in 2008). In 2008, 81 percent of the TB cases were diagnosed in people born outside of the United States. Eight percent of cases were drug-resistant to at least one TB medication. King County reported three cases of multi-drug resistant TB (MDR-TB) in 2008. An additional three cases of MDR-TB were diagnosed in other US health jurisdictions in 2008 and transferred to continue treatment in King County. No cases of extreme-drug resistant TB were reported in King County.
• Child immunization coverage for King County has increased in recent years. Approximately 71 percent of children had completed the recommended 4:3:1:3:3:1 vaccine series in 2006 (the last year of available data), an increase of almost 20 percent since 2002. About 76 percent of children had completed the 4:3:1:3:3 series (excluding varicella, or chickenpox) which is approaching the national goal of 80 percent by 2010. Updated data on immunization rates is anticipated for 2010.

What else influences these indicators?

Reports of communicable diseases are affected by completeness of reporting and improved diagnostic methods; the natural waxing and waning of infections; and personal habits and environmental factors such as exposure to animals, consumption of contaminated food or water, mishandling of food during storage and preparation, and travel.

HIV occurrence is affected by multiple factors, including sexual behaviors among men who have sex with men and the occurrence of other sexually transmitted diseases that can increase the risk of HIV transmission during heterosexual sex.

TB occurrence is influenced by changes in immigration patterns, increases in local or international poverty, and access to early diagnosis and treatment.

Childhood immunization rates are affected by the extent of vaccine distribution programs, caretaker willingness to have their children immunized, and provider commitment to providing vaccinations (e.g. complementary care providers may not encourage immunizations).

What role does King County government play?

King County protects residents from HIV, TB and other communicable diseases; food-borne infections acquired in restaurants; and supports disaster planning and communication lifelines to at-risk communities.

The county prevents transmission of HIV through counseling and testing programs, education programs that offer advice on safer sexual practices and other risk reduction strategies, and efforts to decrease transmission from contaminated intravenous needles used by addicts through promoting access to sterile injection equipment and opiate replacement treatment.

The TB control program focuses on assuring the complete and appropriate treatment of persons with active tuberculosis in partnership with health providers, the Health Care for the Homeless Network, and homeless shelters.

King County investigates reports of communicable diseases and takes action to prevent additional infections through prompt identification of outbreaks, detection of contaminated foodstuffs and prevention of person-to-person spread.

The county increases access to childhood immunizations though the Vaccines for Children program which makes low-cost vaccines available to all children. Public Health monitors immunization rates, conducts quality assurance clinic visits and offers technical assistance to improve rates.