Submitted by admin on Thu, 2005-10-06 23:00. ::
Tanya Oemig, director of the tuberculosis program for the Wisconsin Health and Family Services Division of Public Health's Bureau of Communicable Diseases, said the total number of reported cases in the state in 2003 reached a record low of just 66. But in 2004, that number jumped to 95. Though there's no certain way to identify the cause of the increase, Oemig said the state must stay alert so the disease does not become a real threat.
Beloit's first case of tuberculosis this year was identified in early September and the Beloit Health Department is working with the patient on treatment procedures.
Health departments are required by state law to be active participants in the treatment of tuberculosis cases, because of the highly involved process of curing the disease.
While that is good news, Dalton said when dealing with communicable diseases, there is such a thing as the ”curse of low incidences" - the danger that the health community could let its guard down.
Oemig's office works closely with health departments across the state to monitor cases of tuberculosis and to update them on new treatments and research. The bureau also provides financial assistance to patients who are uninsured and need medical attention. Oemig said the department's main concern is preventing the spread of the disease.
Dalton explained that there is a difference between carrying the tuberculosis infection and actually having the disease. Those who have been exposed to the disease may be carriers and have a positive response to a skin test.
The actual disease is identified through chest X-rays and samples of sputum - fluid from the lungs. Though the disease usually settles in the lungs as respiratory tuberculosis, it can spread to other areas of the body in the form of extra pulmonary tuberculosis. In the case of a 4-year-old child who died in Wisconsin this year, the tuberculosis was identified in the spinal fluid.
Carriers of the infection are not contagious but are treated with medication to prevent the infection from developing into the active disease. Tuberculosis symptoms include excessive coughing, night sweats, weakness and fatigue and weight loss. The disease can be spread to others when an infected person coughs, but not all people exposed to the disease will contract it.
Where health departments must be cautious is ensuring their patients finish their medication. If the patients do not, they can become resistant to the drug and put themselves at greater risk in the future.
Thus, the health department follows a direct observed therapy; public health nurses must watch the patient take the dose every day for the initial two weeks. Then the frequency may be reduced to a few times a week. The treatment can take six to nine weeks. Often times, the patient will be considered non-contagious within a few weeks of treatment. Until that time, patients may be put on home quarantine to protect others from being exposed. If the individual lives with other family members, he or she may have to wear a mask.
If the other inhabitants in the home test positive as carriers of the infection, they too will be treated. The health department then looks outside the home to others who may have been exposed.
Beloit's case this year was diagnosed by a service provider. The state lab tested samples collected by the provider and immediately notified Beloit's health department, as required by law.
Dalton said the patient had come to Beloit from another area of the country fairly recently and had lived previously outside of the United States.
One third of the world's population is infected with the bacteria, though not necessarily the active disease, according to Oemig. Annually, Oemig said, there are three million deaths worldwide associated with tuberculosis.
Elderly people are also more at risk to be carriers, as they could have contracted it before public awareness had been raised about treatment and prevention.
Oemig said tuberculosis has been successfully combated with medicine since the 1950s and now researchers are looking at possible vaccinations against the disease.
Wisconsin enjoys one of the lowest tuberculosis rates in the country, but Oemig and Dalton stressed the importance of keeping pace with the disease.
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