Tuberculosis Hidden from the Public

The worst tuberculosis epidemic in 20 years was kept secret for eight years in Jacksonville, FL was the news in 2010.. The news of this outbreak from the CDC came shortly after the only hospital for patients with tuberculosis, located in Lantana, FL, was closed due to budget cuts. At this time 13 have died and 99 are ill. This outbreak was first discovered in November, 2008, with 18 active cases.

According to the Florida’s Surgeon General, John Armstrong, the likelihood of this disease spreading to the general public is very low. Is that relevant? Isn’t the spread of this disease to anyone still a tragedy? Dr.Armstrong visited Jacksonville to calm fears about this situation, but the fact is this disease should have been dealt with more aggressively from the beginning.

The CDC became aware of this problem in June, 2009, when an assisted living facility requested the Department of Health in Jacksonville investigate. At that time there were 9 cases of primary tuberculosis, and the CDC made recommendations to treat the affected individuals and address the outbreak.

However, the disease began to spread to homeless shelters and places that serve the homeless. At that point, in ‘February 2010, the CDC was asked to investigate again. The general public was still not aware of this problem. Finally, in April 2012, the CDC returned and stated the TB outbreak is one of the worst in the country in the past 20 years.

Tuberculosis is one of the world’s oldest and deadliest infections, which dates back thousands of years as it has been found in the examination of Egyptian mummies. World wide TB kills 1.4 million people annually, with approximately 9 million people contracting the disease each year.There is a vaccine, primarily given to babies and children, in high risk countries.

Pulmonary tuberculosis (TB) is a bacterial infection caused by Mycobacteroium tuberculosis. It is possible to contract this disease by breathing in air droplets from a cough, sneeze or by being close to someone speaking or singing if the person is infected with the disease. Groups that are at a higher risk include the elderly, infants and the immune suppressed population.

You do not get TB from toilet seats, shaking someone's hand, touching bed linen or even kissing.

Symptoms of TB include:

• Bad cough that lasts longer than 3 weeks
• Chest pain, pain with breathing or coughing
• Coughing up blood or sputum
• Weight loss, weakness and fatigue
• Loss of appetite
• Fever and chills
• Night Sweats

TB is a serious disease that can also attack your kidneys, spine or brain. The signs of involvement for these complications would be specific to the organ affected. For instance, blood in the urine would indicate that TB had spread to the kidneys. There are numerous tests used to diagnosis this disease.

The treatment for TB requires taking several medications for a minimum of 6 to 9 months and can be very complex. Ten drugs are currently FDA approved for the treatment of TB. It is essential an individual being treated for TB complete all of their medications as prescribed or they will end up sick again.

Scientist are testing a promising new drug regimen that in the Phase II trial resulted in the ability to kill 99% of the TB bacteria in a two week period of time. This could result in reducing treatment for some patients by more than a year.

In Jacksonville, some staffers at the homeless shelters, law enforcement and some health officials were aware of the disease, but the public did not become aware until the Times Union Newspaper ran an article on June 5^th. Keeping this information from the public is inexcusable.

The justification on the part of the officials was, “we don’t create unnecessary fear and anxiety” in the general population.Finally on September 26, 2012, the TB outbreak makes front page news as the Health Department chief abruptly retires.

Since I am immune suppressed, I would like to have known sooner to use extra caution in public environments, as apparently my life could depend on that awareness. Clearly public officials cannot know whether this disease will spread to people who are not homeless. One life is no more valuable than another. What if an infected homeless person gets a job as a waiter at a restaurant and is my waiter this evening?