Thursday, March 22, 2012 - 9:29am
Keeping a Large Global Problem Locally Small
Tuberculosis is a disease that we do not hear much about these days. It is something that many of us associate with the 19th and early 20th century, with many literary references to what was called "consumption", and TB sanitariums used to isolate and treat those afflicted with this disease. The fact the Northport Drive office of Dane County Department of Human Services was once a TB sanitarium provides an architectural reminder of how widespread this disease used to be in this area.
Although TB is relatively rare here in Dane County, this disease is currently the world's most prevalent infectious disease killer. TB kills more than 2 million people annually, more than influenza, more than AIDS. It is estimated that one-third of the world's total population is infected.
TB is a bacterial disease that can attack any part of the body, although it most commonly affects the lungs. Some people exposed to TB become infected with the bacteria that cause TB. This infection can take two forms, active or latent tuberculosis. Latent TB is not contagious, but if untreated, 10 percent of those infected will develop active TB disease at some point in their life. In its active form, TB makes people very sick, with symptoms such as coughing, fever, night sweats and weight loss.
Since active TB is so highly contagious, Public Health is required to play a strong role in managing and treating any diagnosed case of active tuberculosis and to identify those who may have been in contact with those diagnosed with TB. 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.
It is the job of our public health nurses to make sure that anyone with a positive TB test receives proper medical evaluation and the appropriate diagnosis, with medication prescribed as needed. For people with active TB disease, public health staff must initially make daily home visits which usually decrease to 5 days a week, to assure that the required medications are taken throughout the treatment period, which can range from 6 months to 2 years. While costly, these visits are the most cost-effective means to protect the community and to prevent the development of drug-resistant strains of TB.
The challenge of TB in Dane County is very real. In 2011, there were 216 cases of latent TB and 13 cases of active TB. But when you take into account how much more widespread the disease is in other regions, and how much international travel erases the distance between far flung locations, TB requires constant local attention.
As part of its ongoing efforts to combat this disease, Public Health Madison and Dane County is sponsoring a TB Summit to bring experts and providers together to discuss and learn more about new developments in the treatment and management of tuberculosis.
According to Kate Louther, Supervisor of Public Health's Tuberculosis program, "All of our actions to manage and treat this disease are costly, but the alternative - the widespread transmission of this potentially lethal disease, is something that no society can ever afford."
March 24th is World TB Day, to remind us of the ongoing challenges that TB presents and of the need for the proper treatment and eventual elimination of this terrible infectious disease.
For a list of frequently asked questions and answers about TB, please see the fact sheet produced by the Centers for Disease Control at http://www.cdc.gov/tb/faqs/default.htm.
Public Health - Madison & Dane County
- Jeff Golden, (608) 243-0302