South Korea's legacy battle with tuberculosis

Yun Yeo-jin, a South Korean man diagnosed with active pulmonary tuberculosis at 22, has made a full recovery. CBS/Handout

Yun Yeo-jin
Yun Yeo-jin, a South Korean man diagnosed with active pulmonary tuberculosis at 22, has made a full recovery.
CBS/Handout
Yun Yeo-jin, a South Korean college student engulfed in his computer engineering studies, had never given much thought to tuberculosis. He assumed it was a disease which plagued poor countries. Then, at 22, he was diagnosed with the pulmonary disease early in 2008.

When Yun got a mandatory physical as a cadet for the Reserve Officers Training Corps (ROTC), a doctor told him that his chest x-ray results looked abnormal. Yun was referred to a bigger hospital, where a more advanced scan showed his left lung specked with white dots, some as big as quarters. The diagnosis was active pulmonary tuberculosis.

"When I asked the doctor how I could have contracted TB, he simply said, "It's a disease you get if you're out of luck,'" the now-healthy Yun recalls with a chuckle.

South Korea has the highest incidence rate of tuberculosis among the world's wealthiest countries, nations which belong to the 34-member Organization for Economic Cooperation and Development (OECD).

In 2010, South Korea's incidence rate of tuberculosis was 97 out of 100,000, according to the World Health Organization (WHO), while the mortality rate of TB was 5.4 out of 100,000. (In the U.S., the incidence rate was 4.1 and the mortality rate was 0.18 during the same time period.)

In 2010, TB claimed the lives of 2,365 Koreans, according to the Korea Centers for Disease Control and Prevention.

Experts say the burden of tuberculosis in South Korea today is primarily a legacy of the Korean War. Fighting stopped more than 60 years ago, but the poverty, cramped living spaces and limited medical treatment during and after the war created ideal conditions for the TB bacteria to spread.

In the 1950s and '60s, as much as 70 percent of the population was exposed to TB, explains the director of the Korea Institute of Tuberculosis, Kim Hee-jin.

In general, only 10 percent of those exposed to TB will ever get the active form of the disease, which is contagious. Although most South Koreans who were infected decades ago have only inactive or latent TB, some of them develop the active form of the disease as they age and their immune systems weaken. And they are spreading it to others. Many of the cases today are a reactivation of old infections that occurred decades ago, medical experts believe.

"The only way to bring down the incidence rate is to wait for the generation above 40-50 years of age to disappear," says Kim. "We can't dramatically decrease the incidence rate in the next few years with the technology we have today."

Public health officials made great strides in detecting and treating tuberculosis patients from the 1960s to the early 1990s, but the campaign against TB has lost its steam since 1995, says Cho Eun-hee, who oversees the TB program at the Korea Centers for Disease Control and Prevention.

"They let go of their grip [over tuberculosis] for nearly 15 years from 1995," she adds.

Cho says more recently, as South Korea's TB incidence rate rose well above other industrialized countries, it has became a matter of "national dignity," and the nation's leaders have again recognized the need to address the problem.

Last year, the South Korean health ministry quadrupled the annual budget for its tuberculosis program from previous years to 45 billion won ($39.9 million).

The World Health Organization's Western Pacific Office tells CBS News "renewed government commitment, strong technical capacity and increased public attention" have led South Korea to "a critical window of opportunity to accelerate TB control."

In spite of the renewed effort, Kim Hee-jin, the director of the Korea Institute of Tuberculosis, says the health ministry still needs to increase the detection of latent TB and provide more preventive treatment to people who have it.

Experts agree that the long-term public health goal of reducing the incidence rate of TB in South Korea by a quarter by 2020, and eliminating it completely by 2030, are infeasible.

"They're more forward-looking goals rather than realistic ones," says Cho of the Korea Centers for Disease Control & Prevention. "Koreans tend to push ahead with their plans, so even if there are difficulties, how we break down those problems matters most."

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