Monday, March 24, 2014 - 12:57pm
TB is a Global Plague and a Local Challenge
Many of us tend to think of tuberculosis as a disease of the 19th century with little relevance to the 21st century. So it comes as a surprise to learn than TB is second only to HIV/AIDS as the greatest killer worldwide due to a single cause of infection. In fact in 2012, there were an estimated 8.6 million new cases of TB with a death toll of 1.3 million, 74,000 of which were children. We are lucky to have much lower numbers in this country. Here in Dane County, Public Health is currently managing 7 active cases.
World TB Day commemorates the date in 1882 when Dr. Robert Koch announced his discovery of Mycobacterium tuberculosis, the bacillus that causes tuberculosis (TB).
The disease itself usually attacks the lungs but can also attack other parts of the body such as the kidney, spine, and brain. Without proper treatment, TB can be fatal. In fact it used to be the leading cause of death in the United States. The Northport Drive office of Dane County Department of Human Services was once a TB sanitarium, an architectural reminder of how widespread this disease used to be right in this area.
Since the disease is highly contagious, even the relatively low number of cases requires an extraordinary amount attention and management. Public Health - Madison and Dane County (PHMDC) is legally obligated to track every active TB case in the county and identify all those individuals who have had contact with the patient. Our public health nurses (PHNs) initially visit each active TB client every day, to assure that the required medications are taken throughout the treatment period. While costly, these visits are the most cost effective means to 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. 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.
According to Kate Louther, the PHMDC manager who supervises the TB program, “dealing with TB represents a huge investment of time, effort and resources by both public health and the health care system. In some cases these efforts even involve the judicial system. It´s a lot of resources and a lot of money, but it is bargain when weighed against the possibility of uncontrolled and widespread transmission of a potentially lethal disease."
For a list of frequently asked questions and answers about TB, click here to see the fact sheet produced by the Centers for Disease Control.
- Jeff Golden, Public Health Madison Dane County, (608) 243-0302