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Board of Health: Cowlitz County sees more active tuberculosis cases, offers rabies education; plans follow-up on water fluoridation and vaccine safety
Summary
Public health staff reported a rise in directly observed tuberculosis cases and offered public education about rabies exposures (primarily from bats). The Board of Health agreed to track state and federal activity on water fluoridation and to schedule a future session on vaccine safety and public information.
Cowlitz County's Board of Health heard an update from public-health staff covering a surge in administrative workload (birth- and death-certificate processing), active tuberculosis cases requiring directly observed therapy, routine food and pool inspections, and rabies-prevention guidance emphasizing bats as the primary local vector.
Public-health staff reported that birth-certificate orders are up about 65% compared with the same time last year—driven by increased demand related to Real ID requirements—and that front-counter processing is taking longer per transaction. Community-health nurses reported they are managing multiple active tuberculosis cases; staff said two active, treated tuberculosis cases are ongoing in the county and that direct observation of therapy (DOT) or video DOT is being used to ensure adherence to multi‑month treatment regimens. "We have 2 active cases right now," public-health staff said, and they emphasized DOT to prevent drug resistance and protect public health.
The board also received a zoonotics/rabies briefing from the health officer. Dr. Kroeger (Health Officer) said rabies remains a serious but rare risk in Washington and that bats are the principal local concern. He urged residents to avoid handling bats and to seek medical guidance immediately if a bite or exposed contact is suspected. "If you contract rabies and start developing symptoms, things are not good," he said, noting that prompt post-exposure prophylaxis (vaccine and immunoglobulin) prevents progression to fatal disease. Staff explained the testing protocol: animals must be euthanized for brain testing, so an intact specimen can speed confirmation and potentially avoid prophylactic injections in exposed people.
Why this matters: tuberculosis treatment requires sustained public-health resources to prevent drug-resistant cases; rabies exposures from bats are time-sensitive and can require painful post-exposure treatment. The health department's ongoing inspection work (about 600 food inspections reported year-to-date) and seasonal pool and temporary-event oversight were also highlighted as high workload items.
The board discussed water fluoridation after public comment and staff noted the EPA and the state board of health are reviewing new studies on fluoride. County staff clarified that Cowlitz County does not fluoridate the small water systems the county operates; Longview and Kelso make their own water-chemistry decisions and Longview recently retained fluoridation because of a contract with Beacon Hill Water District. A resident speaker raised concerns about lack of informed consent when municipalities add medicating agents to drinking water. The board asked the health officer to report back with a state-level update on fluoride in approximately three months.
Finally, board members asked the health officer to prepare a public education session about vaccines and vaccine safety; the health officer said he would develop an educational presentation that could cover vaccine types, clinical-trial processes and post-market safety monitoring.
Ending: The health department will continue TB and rabies case work, maintain seasonal inspection activities, monitor state and federal work on fluoride, and schedule a future vaccine-focused briefing for the board and public.
