TB: A Persistent Global Burden
The leading cause of death in 19th century America continues its devastation today-throughout the world. While cases of TB in the U.S. have steadily declined in recent years, this is no reason for complacency. Consider the following sobering facts:
- Tuberculosis kills 2 million people worldwide each year.
- Every second, someone in the world is newly infected with the TB bacteria.
- One third of the world's population is currently infected with the TB bacteria.
- Every year, 8 million of those with TB infection develop TB disease.
- By 2020, the World Health Organization (WHO) estimates that there will be 1 billion TB cases worldwide and 35 million deaths from TB.
TB in its modern version is harder to treat, given the rise in multi-drug resistant strains of TB. These stronger, more virulent strains of TB are challenging the effectiveness of existing TB medications, and may herald the beginnings of a modern-day TB epidemic if TB control measures do not adequately address TB's international, multi-drug resistant face.
www.iuatld.org/html/ body_online_declaration.htm
Be part of the international fight against TB. Participate in the Year 2000 campaign by the International Union Against Tuberculosis and Lung Diseases by signing an electronic petition to support tuberculosis treatment for all.
The Changing Face of TB in America
While TB cases in the U.S. have slowly but steadily declined following a resurgence of cases that peaked in 1992, TB is and still should be of concern to all. The increasing globalization of economies and travel means that this airborne disease can spread outside of countries where it is endemic. In 1998, 41% of the TB cases in the U.S. were among persons born in other countries. Most of these individuals came from countries where TB is highly prevalent.
The challenge in controlling the TB problem is that TB does not recognize borders of any kind-whether they be of nations, race, or income. TB is more common among certain populations than others, but it can strike anyone. Today, the number of TB cases in the U.S. is declining, but there is a substantial pool of infected persons that are the source of TB cases in the future.
The Changing TB Control Strategy
It is estimated that 10-15 million Americans have TB infection. About 5-10% of these persons will develop TB disease at some point in their lives. This reservoir of potential future TB cases offers the opportunity to prevent TB disease through screening persons who are likely to be infected and offering infected persons medical treatment to prevent them from developing disease. This preventive strategy, coupled with continued vigilance in identifying and treating existing TB disease cases, underscores the renewed focus on both prevention and disease treatment.
TB in San Diego & Imperial Counties: A Local Perspective
San Diego County
Please see the San Diego County TB Control Program website for San Diego County TB facts.
www.co.san-diego.ca.us/cnty/ cntydepts/health/ services/ tb/education.htm
Cure TB
This program aims to improve continuity of care for persons with TB who travel between the United States and Mexico. CURE-TB accepts patient referrals from U.S. and Mexico providers and acts as an information link between U.S. and Mexican providers.
To contact the bilingual CURE-TB staff, please call 619-692-5710 or 800-789-1751.
For more information about the program, please see:
www.co.san-diego.ca.us/ cnty/cntydepts/ health/services/tb/cure_tb.htm
Imperial County
Imperial Valley is a Hot Spot for TB
While the number of TB cases in Imperial County does not approach that of the much larger San Diego County, Imperial has the distinction of having the second highest TB case rate among counties in California. The TB case rate is a measure of how prevalent TB is in a given population size. Imperial County's TB case rate is 26.1 per 100,000 persons. So while the County had a relatively low number of TB cases (38 in 1999), its case rate is remarkably high when the County's population size is taken into account.
Regional Cooperation
Given Imperial County's proximity to our neighbors in Mexico and Arizona, TB control efforts in the County have taken on a regional focus. At the heart of this integrated approach is a regular meeting that is attended by TB providers from Yuma (Arizona), San Luis (Mexico), Mexicali (Mexico), and Imperial County to discuss mutual TB cases and concerns. These quarterly meetings rotate among the participating sites.
Promotoras Reach Out to the Community
The Imperial County Health Department and the Border Health Initiative of Project Concern International are working on an innovative binational education program that aims to educate people about TB, HIV/AIDS, and substance abuse. The TB component of this multi-year project deploys trained "promotoras" or community health workers throughout the communities of El Centro, Calexico, and Heber to educate community residents about the disease. The promotoras motivate residents to access health services within the community and provide support and follow-up to assure that residents receive services. For additional information about this project, please contact the Imperial County Health Department at 760-482-4472.
