Posted on 03/18/2007 9:57:15 AM PDT by SJackson
Dr. Thomas Schlenker Although the threat of a devastating influenza pandemic is real, the greater global infectious disease threat today, for most of the last 500 years and for the foreseeable future, is tuberculosis.
The basic facts about TB are astonishing.
Tuberculosis kills 2 million people every year.
One third of the world's population is infected. New, mutant strains, resistant to our most powerful antibiotics, called multi-drug resistant tuberculosis (MDR-TB), ravage Asia, Africa, and Eastern Europe and regularly find their way even to Wisconsin. This past year, Public Health Madison-Dane County identified and treated nine individuals with TB, two of whom had MDR-TB.
The cost of effectively treating those infected with MDR-TB is hundreds of thousands of dollars per patient. This huge investment of time, effort and resources by the health care system, public health and, sometimes, the police and judicial system, is nevertheless money well spent. It's money well spent in that the alternative to treatment is death for the patient and possible widespread transmission of a potentially lethal disease to the community.
Contagious influenza, even the pandemic varieties, is short-lived and survivable by most healthy people with no treatment at all. But untreated MDR-TB is almost always fatal and can be transmitted over an extended period of time.
Like pandemic influenza, effective TB response requires that local and state public health agencies work closely and creatively together with clinical physicians, hospital systems, the police, courts and social services. Unlike pandemic flu, which visits us unpredictably every 10 to 30 years and thus allows for only simulated preparation, TB is a constant presence that requires real-time responses that carry real-time consequences whereby we learn by doing.
Issues like mass screening, isolation and quarantine, public notification, nontraditional treatment regimens and in-home support are confronted every day.
To my mind, the ongoing practice of high-quality TB control is the best way to prepare for the expected influenza pandemic.
As the director of the local public health agency, I appreciate the flow of federal bioterrorism dollars that have allowed us to improve our emergency response infrastructure since 9/11. On the other hand, the recent news story - "More than five years after the Sept. 11 attacks, the government cannot show how the $5 billion given to public health departments has better prepared the country for bioterrorism attack or flu pandemic" - does reflect that at least some of those billions might have been better spent.
March 24 is World Tuberculosis Day - an appropriate time to propose that investment in TB control and other core public health functions is perhaps the best way to be truly prepared.
Dr. Thomas Schlenker is the director of Public Health Madison-Dane County.
The findings indicate that although the 2005 TB rate was the lowest recorded since national reporting began in 1953, the decline has slowed from an average of 7.1% per year (1993--2000) to an average of 3.8% per year (2001--2005). In 2005, the TB rate in foreign-born persons in the United States was 8.7 times that of U.S.-born persons.* In addition, Hispanics,† blacks, and Asians had TB rates 7.3, 8.3, and 19.6 times higher than whites, respectively. Moreover, the number of multidrug-resistant (MDR) TB§ cases in the United States increased 13.3%, with 128 cases (up from 113 in 2003) of MDR TB in 2004, the most recent year for which complete drug-susceptibility data are available.
More than half (56.0%) of the foreign-born cases in 2005 were reported in persons from Mexico (1,930), the Philippines (826), Vietnam (576), India (563), and China (389).
For 2005, and for the second consecutive year, more TB cases were reported among Hispanics than any other racial/ethnic population. Among persons of a racial/ethnic minority whose country of birth was known, 3,034 (95.9%) of 3,164 Asians, 3,021 (75.4%) of 4,005 Hispanics, and 1,049 (26.7%) of 3,927 blacks with TB were foreign-born.
If immigration patterns continue, foreign-born persons will likely account for an increasing percentage of TB cases in the United States.
To address the high rate of TB among foreign-born persons in the United States and the increasing proportion of cases they represent, CDC is collaborating with other national and international public health organizations to 1) survey foreign-born TB patients in the United States to determine opportunities for improving prevention and control interventions, 2) test recent arrivals from high-incidence countries for latent TB infection and treat them to completion, 3) optimize coordination of TB-control activities between the United States and Mexico to ensure completion of treatment among TB patients who travel back and forth across the U.S.-Mexican border, 4) strengthen the current notification system that alerts local health departments about the arrival of immigrants or refugees who have suspected TB, 5) enhance TB diagnostic, laboratory, and treatment capacities in host countries and sites where migrant populations are screened, and 6) improve overseas screening of immigrants and refugees by systematically monitoring, evaluating, and updating screening regulations, guidelines, and operations. CDC also continues to collaborate with international partners, including the Stop TB Partnership (http://www.stoptb.org), to strengthen TB control in countries with high TB incidence.
And no, I'm certainly not making any connection with TB and immigration, legal or otherwise.
Illegal invaders are bringing one of the world's most dangerous biological weapons of mass destruction with them.
"One third of the world's population is infected."
Wild claims like this are sure to decrease the credibility of an article which otherwise sounds very legitimate alarms and concerns.
Yes and the public health department seems to have forgotten one of the greatest weapons they have with diseases. QUARANTINE
1/3 of the world's population probably has inactive, latent TB. It can reactivate in stress, old age, or if you become immunocompromised or it may not reactivate at all.
A lot less have active TB, which is making them sick right now.
As the director of the local public health agency, I appreciate the flow of federal bioterrorism dollars that have allowed us to improve our emergency response infrastructure since 9/11. On the other hand, the recent news story - "More than five years after the Sept. 11 attacks, the government cannot show how the $5 billion given to public health departments has better prepared the country for bioterrorism attack or flu pandemic" - does reflect that at least some of those billions might have been better spent.
March 24 is World Tuberculosis Day - an appropriate time to propose that investment in TB control and other core public health functions is perhaps the best way to be truly prepared.
Dr. Thomas Schlenker is the director of Public Health Madison-Dane County.
"Illegal invaders are bringing one of the world's most dangerous biological weapons of mass destruction with them."
This along with AIDS and resistant forms of TB has brought about a a resurgence of this scourge. PC in the Public Health community is the real enemy. We can't quarantine Illegals or AIDS sufferers with TB because the MSM would make it seem like a reactivation of Bergen-Belsen.
A Virologist friend would also like to ban all travel to Africa because of Hepititis-C. The next pandemic.
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