TB Cases in Korea

One of the most common myths about TB is that it only occurs in the lower socioeconomic groups; it is only a problem in developing countries. Surprisingly, TB has been a serious problem in Korea, even though its nominal gross domestic product (GDP) is ranked at 15th in the year 2012 according to the World Bank.

The report in 2007 by the World Health Organization (WHO) showed that South Korea was ranked first out of the 30 countries of the Organization for Economic Co-operation and Development (OECD) in TB incidence, prevalence, and mortality. According to the Korea Centers for Disease Control and Prevention (KCDC), TB has remained the top infectious disease in South Korea since 2000, except in 2009 and 2010; a new flu emerged as the most infectious disease during these two years. The KCDC statistics shows that a total of 39,545 new cases of TB were reported last year. This represents 43 percent of 91,136 cases of the five major infectious diseases: TB, chickenpox, mumps, scrub typhus, and hepatitis B.

Why is TB such a widespread disease in Korea? According to Columbia Broadcasting System (CBS) News, the news division of the United States television and radio network, the consensus among the experts is that the burden of TB in South Korea today is primarily a remnant of the Korean War, even though the fighting stopped more than 60 years ago. The poverty resulted from the cramped living spaces and limited medical treatment during and after the war. This eventually created the ideal conditions for TB bacteria to spread throughout Korea. Hee-jin Kim, the director of the Korea Institute of Tuberculosis, said that about 70 percent of the total population of South Korea was exposed to TB in the 1950s and 1960s.

Then, how about the TB infection throughout North Korea? Obviously, the conditions are worse. WHO figures released in March showed 99,074 TB cases reported in 2011. The figure is 2.5 times that of South Korea. The death rate was 6.4, which is about 1.4 times the figure for South Korea.

While two countries both have high rates of TB infection, the attitudes toward such issue are quite different. Physician Kwonjune Justin Seung, who is considered one of the top experts in multidrug resistant tuberculosis (MDR-TB), compared the reactions to the disease in North and South Korea in an interview with Hankyoreh News.

According to Seung, there is a widespread belief in South Korea that the current treatment should be good enough to handle the nation’s TB problem because of the country’s advanced economy and quality health care system. On the other hand, North Korea accepts the widespread infection of TB - the attitude is that the issue of TB should take a backseat to more pressing issues for now.

The government has been focusing on reducing the number of TB patients nationwide to the level of developed countries by 2020. Nearly 100 billion Korean Won was spent as the total government expenditure for TB prevention and treatment from 2009 to 2012. But despite the efforts of the government, the TB situation is not getting any better. The latest figures from WHO showed a death rate of 4.7 deaths per year per 1000 people, which is only slightly lower than the rate of 4.9 from four years prior. The number of reported patients even increased by 5,000 from 2007.According to experts, this 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 deemed unrealistic.

This is not a surprise to me. When I was in Korea, there were many eastern european or russian prostitutes. Those countries have a high prevalence of HIV and drug resistant tuberculosis. According to my colleague, the women are popular with men, and it seems too many men do not use condoms. This is not a surprise.

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TB Cases in Korea

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