Tuberculosis remains Public Health Concern in Southwest Georgia

During 2007, Southwest Georgia Public Health officials identified 25 adults and four children with tuberculosis, including one patient with a strain of TB resistant to the primary drugs used for treatment. An additional 247 adults and 15 youngsters were treated for latent TB, which causes no symptoms and is not contagious, says District TB Coordinator Dan Staib.

"Two of the children were under fiveyears of age," Staib said. "The signs of TB in children are more subtle, and people don't necessarily think of tuberculosis being a concern in our community in this day and age. But the fact is, TB is the No. 3 killer of children."

The drug resistant strain reported here was not the XDR

(Extensively Drug Resistant) TB that hit the news when an Atlanta man thought to have honeymooned abroad, raising concerns about the potential exposure of fellow airline passengers and close contacts.

"The patient here has responded to other medications and is doing well," said Southwest District Health Director Dr. Jacqueline Grant.

Tuberculosis is on the decline in the United States. In 2006, 13,779 cases were reported to the National Centers for Disease Control, which represents a 2.1 percent decrease from the previous year, Grant said.

"Yet certain populations in the country are showing an increase in TB infections. The percentage of cases in foreign-born persons is rising. Hispanics and Asians together represented almost 80 percent of TB cases in foreignborn persons, and accounted for 45 percent of the national case total," she said.

Further, a disproportionate number of African Americans contract the disease, Grant said. "In 2005, TB was reported in 3,927 black, non-Hispanic persons, 28 percent of the cases reported nationally. In 2005, the rate of TB in black, non-Hispanic persons was 10.8 cases per 100,000 population, which is approximately eight times the rate of TB in white, non-Hispanic persons (1.3 cases per 100,000 population)."

The disparity grows even more pronounced if only US-born African Americans reported with TB are examined, she continued. "Among US-born persons reported with TB in 2005, 45 percent were African Americans (black, non-Hispanic)."

Tuberculosis is spread through the air when a person with an active TB infection in the throat or lungs coughs or sneezes, Staib said. "People nearby may breathe in these bacteria and become infected. The bacteria can settle in the lungs and begin to grow. From there, they can move through the blood to other parts of the body, such as the kidney, spine, and brain," he said.

Staib stressed, however, that not everyone infected with TB bacteria becomes sick. "In most people who breathe in TB bacteria and become infected, the body is able to fight the bacteria to stop them from growing. The bacteria become inactive, but they remain alive in the body and can become active later. This is called latent TB infection."

People with latent TB infection do not feel sick or experience symptoms and cannot spread the disease to others. However, they may develop active TB disease if they do not receive treatment, Staib warned.

"Many people who have latent TB infection never develop active TB disease," he said. "In them, TB bacteria remain inactive for a lifetime without causing disease. But in other people, especially people who have weak immune systems, the bacteria become active and cause TB disease."

Those vulnerable to developing active tuberculosis include TBexposed babies and young children, people with HIV infections, people with diabetes, substance abusers and people with leukemia, severe kidney disease and cancer of the head or neck.

Symptoms of active TB include:

-a bad cough that lasts three weeks or longer

-pain in the chest

-coughing up blood or sputum (phlegm from deep inside the lungs)

-weakness or fatigue -weight loss -no appetite -chills -fever

-sweating at night

During 2006, 28 deaths in Georgia were attributed to TB, including one fatality in Southwest Public Health District. Out of 386 tuberculosis cases reported in Georgia during 2006, 32 were in the Southwest Public Health District.

"Georgia has one of the highest tuberculosis rates in the United States," Grant said. "To improve the state's standing means that we will need to strengthen prevention efforts among high-risk groups such as African Americans, Asian Americans, Hispanics, people infected with HIV and people living in poverty with limited access to medical care and stable housing. We encourage everyone to become more familiar with the signs and symptoms of tuberculosis and to promptly seek testing should these symptoms occur."

For more information about tuberculosis, go on-line to www.southwestgeorgiapublichealth. org.