Tuberculosis – A Global Problem with a Local Challenge
World Tuberculosis Day is an Opportunity to Remind Ourselves of this Threat to Public Health
March 24th is World TB Day which commemorates the date in 1882 when Dr. Robert Koch announced his discovery of Mycobacterium tuberculosis, the bacteria that causes tuberculosis. Some of us may have seen references to tuberculosis (TB) in movies or TV series set in 19th or early 20th century Britain or the U.S., giving the impression that this is a malady of a bygone era. Current realities paint a very different picture. In 2013, globally, 9 million people became ill with TB and 1.5 million of those died from the disease. TB ranks as the second leading cause of death from a single infectious agent, with HIV taking first place. In 2014, the U.S. reported over 9000 cases.
Here in Dane County, Public Health Madison & Dane County (PHMDC) is currently managing 5 active cases including one multi-drug resistant case. Over the last 10 years, we´ve managed on average about 10 cases a year.
Without proper treatment, TB can be fatal. In fact it used to be the leading cause of death in the United States. TB presents an enormous challenge to local public health departments. Because the active form of the disease is so highly contagious, it requires an extraordinary amount attention and management. So even with a relatively low number of cases, PHMDC is legally required to track every active (Pulmonary) TB case in the county and identify all those individuals who have had contact with the patient.
Initially, our public health nurses (PHNs) visit each active TB client daily, to assure that the required medications are taken throughout the treatment period. While costly, these visits are the most cost effective means to both prevent the spread of the disease and to help prevent the development of drug resistant strains of TB.
PHNs also provide education to the patient and family as well as assisting the patient to access the range of help required in order to be successful in treatment. This is no small matter since anyone with active TB disease needs at least 2 weeks of isolation, which usually means that they cannot work.
Many patients live on the brink of poverty and need both medical and other financial and housing support until they are no longer infectious.
There is also a latent form of TB (TB infection), where the body's immune system is able to fight the bacteria and stop them from growing. People with this form of TB have no symptoms, they don´t feel sick, and most importantly, they can´t spread TB to others.
So in addition to the work with active TB patients, PHMDC works diligently to prevent active TB disease by providing screening to at-risk populations and providing medication and case management services to approximately 190 clients with Latent TB infection annually.
According to Erin Polkinghorn, RN, TB Coordinator for PHMDC, “dealing with active TB requires a substantial investment of time, effort and resources by both public health and the health care system. In rare cases we even have to rely on the judicial system to assure that proper treatment continues. On one level, managing TB is extremely expensive, but it becomes a real bargain when the payoff means that we can stop the possibility of uncontrolled and widespread transmission of a potentially lethal disease."
Click here - For a list of frequently asked questions and answers about TB, please see the fact sheet produced by the Centers for Disease Control
