March 19, 2003
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An expert on tuberculosis is worried that recent declines in local tuberculosis rates may be reversed as lawmakers search for ways to cut health funding.
Charles Crane, MD, Medical Director for Contra Costa Health Services' Tuberculosis Program, says he is pleased that the rates of tuberculosis in Contra Costa have dropped dramatically thanks to a combination of education, outreach and individual medical attention, but he is concerned that the improvement may be short lived. New reports will be released on March 24, Work Tuberculosis Day by both Contra Costa and the California Department of Health Services.
"When funding and programs were cut in the 1980s, the rates went up,"says Crane.
In 2002, there were 68 cases of TB in Contra Costa, a decline of 35 percent from 2001. That year, there was a significant increase, especially in West Contra Costa County. Crane praises the county's TB Prevention and Education Program for the improvement. Working with West County Communities Against TB (WCCAT), a resident advisory board, they get the word out to the community about the importance of detecting tuberculosis early, when it can be treated with medication.
Crane also credits the recent decline in TB cases to an important program of directly observed therapy for TB patients, where a health worker observes every dose of medication taken by a patient.
"Teaching people with symptoms to seek help and helping those with the disease to take their medication has made all the difference,"Crane says, adding that despite the good news, TB is still a problem and continued efforts must be made to keep in under control.
"Many TB patients don't seek medical attention at an early stage of their illness, before they become infectious,"Crane says, adding that some patients also fail to tell their medical provider how long they've had a cough, one of the key symptoms of the disease. That often leads to delayed diagnoses, exposure of family members and sometimes even death.
Crane says it is essential for anyone with TB symptoms to consult a doctor to find out if they have the active disease. Symptoms of TB disease typically include a cough with phlegm lasting three weeks or more, usually accompanied by unintentional weight loss of at least 10 pounds, fevers or night sweats.
"TB is transmitted from person to person through the air when a patient with active TB disease coughs or speaks. Most people who are infected with the TB germ do not have the active form of the disease. They have no symptoms and are not infectious. However, they carry the germ, which can grow and lead to the active, infectious disease at any time,"Crane says.
In the early stage, the infection can only be diagnosed with a simple skin test, called a PPD. If the test is positive, a single medication, called INH, can be taken for six to nine months to prevent TB infection from becoming active disease.
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