San Rafael, CA – Tuberculosis, or TB, is one of the world’s deadliest infectious diseases, responsible for more deaths each year than HIV/AIDS. In 2016, nearly 1.7 million people worldwide died of TB even though the disease is preventable and curable.
Marin County Health and Human Services is marking World TB Day on March 24 and getting the message out that the disease has not been fully eradicated like smallpox. Marin recorded four cases of TB in 2017, all non-fatal.
“Many think TB is a thing of the past, but that is far from true,” said Dr. Lisa Santora, Deputy Public Health Officer. “We see a small but steady number of TB cases each year. What’s also concerning is that we know there are people with latent TB infection who do not have symptoms but can develop active TB if untreated.”
More than 2,000 people are diagnosed with active TB in California every year, making up just over 20 percent of all TB cases diagnosed across the nation. Symptoms of active TB disease can include a cough for more than two to three weeks, coughing up blood, shortness of breath, fever, night sweats and weight loss. Marin’s four reported cases in 2017 represented a decrease from 2016 (six cases), 2015 (nine cases) and 2014 (nine cases). Marin had one death related to TB in 2016, although the individual had other long-term health problems.
Active TB can be prevented by testing for and treating latent TB infection, where a person is infected with the bacteria but does not have symptoms. It is estimated that over 2 million Californians have latent TB infection. If not treated, people with TB infection have a 5-10 percent lifetime risk of developing active disease, and that is the cause of the majority of California’s active cases. Similarly, every year Marin has cases of individuals who had latent TB infection and did not develop active disease until older adulthood.
In 2016 the United States Preventive Services Task Force recommended more targeted screening for latent TB for high-risk groups. The TB rate among people born outside of the U.S. is 12 times higher than those born here. Those groups include people born in, or former residents of, countries with increased TB prevalence (among them Mexico, the Philippines, Vietnam, India, China, Haiti, and Guatemala). Also, those with suppressed immune systems who currently live in, or have lived in, homeless shelters, long-term care facilities, correctional facilities, and other high-risk congregate settings are at higher risk for TB.
Screening and treatment are essential to wipe out TB. If you have a risk factor for TB or are unsure, ask your health care provider about testing and treatment.
Marin County’s Communicable Disease Prevention and Control team (CDPC) provides extensive support to Marin’s TB patients, ensuring they have access quality medical care, removing barriers to treatment, and monitoring medication adherence daily. Medication compliance is critical, and CDPC uses video conference technology to observe a patient taking medication. Marin CDPC also works to prevent the spread of TB by identifying people who have been exposed to actively sick individuals to offer preventative screening and treatment as needed.
Additionally, Marin County Public Health is partnering with clinics in the community such as Marin Community Clinics to help improve screening and treatment and strive for a TB-free world.