Tuberculosis on rise in state but uncommon in Clark County

Still, local man’s death reminder of its risks

By Marissa Harshman, Columbian health reporter

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For the first time in several years, the number of tuberculosis cases in Washington is on the rise.

While the number of cases in the state increased by 13 percent in 2013, Clark County’s case numbers remain low.

In 2012, state health officials recorded 185 TB cases. Last year, the number of cases climbed to 209 — the first increase since 2009.

photoJay Candee, shown here in an undated photo, died of tuberculosis in October.

In Clark County, five people were diagnosed with TB in 2013, continuing the downward trend locally. But for only the second time in at least seven years, someone died from TB in Clark County.

Ridgefield resident Jay Candee, 59, died from undiagnosed tuberculosis on Oct. 29.

“Jay had no next of kin, but there are many people who will miss him greatly, and we are spread out all over this country from Alaska to Maine,” said Larry Till, who was friends with Candee for about 20 years.

Candee grew up in the area and graduated from Hudson’s Bay High School in 1972. Candee was a traveler by nature and visited or lived in nearly every state, Till said.

For about 10 years, Candee lived in Whittier, Alaska, where he maintained and repaired fishing boats, Till said. After moving around for a few years, Candee landed back in Clark County a couple years before his death.

Symptoms of tuberculosis

General symptoms of active tuberculosis disease include fever, night sweats, weight loss and tiredness. Symptoms of TB disease in the lungs also include coughing, coughing up blood and chest pain.

Source: Washington State Department of Health

Candee and his constant companion — his dog named Odin Brown that was most often just called “Brown Dog” — lived in his 1970s Winnebago Warrior in Ridgefield, Till said.

For at least a month and a half prior to his death, Candee had been ill. Candee had been recently treated for a serious hernia and had been seeing a doctor in Portland, Till said.

Candee told friends that he told his doctor he was having difficulty breathing, but his doctor attributed the problems to dog hair. Till said he never found any medical records related to Candee’s condition at the time of his death. The Clark County Medical Examiner’s Office concluded the cause of death was tuberculosis.

photoClick to enlarge.

After his death, another of Candee’s longtime friends adopted Brown Dog. Candee’s friends plan to take his ashes to a place Candee came across during his final road trip — a place he described as a slice of heaven on earth.

“The many whose lives he touched will remember him fondly and with tremendous affection,” Till said. “Jay had a heart of solid gold, and he will be missed.”

Monitoring TB

Tuberculosis can be treated if it’s detected. Left untreated, however, the disease can be fatal, said Dr. Alan Melnick, Clark County Public Health director and health officer.

Tuberculosis is caused by a bacterium that attacks the lungs, but it can also attack other parts of the body, such as the kidney, spine or brain. TB is spread through the air from one person to another. The bacteria spread when a person with TB of the lungs or throat coughs, sneezes, speaks or sings, and people nearby inhale the bacteria, according to the Centers for Disease Control and Prevention.

Unlike some other contagious diseases, TB germs can’t survive in the environment for long. Transmission usually requires being in close proximity to someone for a prolonged period of time, such as family members or colleagues who share an office space, Melnick said.

“I don’t want people to panic (and think) they’re going to run out and get tuberculosis,” he said.

And even if someone does get TB, they may not get sick.

There are two varieties of tuberculosis: active disease and latent infection. A latent infection is when the bacteria live in the body but are not making the infected person sick. People with latent TB cannot spread the bacteria. Active TB disease occurs when the immune system can’t stop the bacteria from multiplying in the body. About 10 percent of people with a latent TB infection develop active TB, Melnick said.

Those with TB — either latent infection or active disease — are treated with a variety of medications. Treatment can last for several months but is generally effective, Melnick said.

County health officials are currently monitoring six cases of active TB and one additional suspected case, Melnick said. They’ll continue the monitoring throughout treatment.

While TB does exist in the community, the majority of the population is not at risk and doesn’t need screening or testing for the disease, Melnick said.

“The average person is really not at risk for TB because there’s so little of it in the community,” he said.