Katrina Networking

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Tuesday, January 09, 2007

TB on Rise

3/22 - http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5611a2.htm?s_cid=mm5611a2_e
Very technical, but Table 1 shows the patterns emerging. Very interestingly, the numbers reported declined in LA and AL, but rose dramatically in MS. If this were exclusively due to foreign born, it would appear in all fishing communities of foreign born, which are in all 3 states.
I hope more comes out, will post more as I find it.

2/1 Another JPS School Hit With Tuberculosis Scare
JACKSON, Miss. -- Students at Isable Elementary were given a letter Wednesday to give to their parents in which Jackson Public Schools warns that a parent came forward saying their child had been diagnosed with tuberculosis.
The letter goes on to explain that the case has not been confirmed by the state Health Department.
The district said it is not sure whether or not the child is contagious, but the student is not in school.
If the case is confirmed, it would be the second TB scare the district has seen this year. A student at Blackburn Middle School tested positive for TB earlier this month. As a result, students and teachers there were all tested for the disease.
The Health Department is not releasing the results of those tests.
Parents at Isable, meanwhile, said they are feeling a little uneasy.
"I think they ought to test all the schools because of the incident at Blackburn. You don't know what sisters and brothers they have elsewhere," Chandra Gathings said.
The symptoms of tuberculosis include a persistent cough with thick, cloudy and sometimes bloody mucus; swollen neck; fatigue; fever; and chills.

1/12 Tuberculosis Scare Hits Blackburn Middle School
JACKSON, Miss. -- Blackburn Middle School students were handed a letter to give to their parents when they dismissed Thursday, saying that a student who attended Blackburn last semester was found to have active tuberculosis disease.
The letter invites parents to attend a meeting at the school to address their concerns and explain how the school plans to handle the situation.
Jackson Public School officials told 16 WAPT that the student has not been back to Blackburn this semester.
The child tested positive for TB over the winter break.
JPS officials said they want to make sure the infection did not spread at Blackburn.
According to the Centers for Disease Control, a person catches TB in much the same way they'd catch a cold. The infected person coughs or sneezes, and TB germs are sent into the air where they can be inhaled.
But being around someone with TB in passing won't spread the disease. Doctors said it does take many hours of exposure to become infected, and most people who breathe in TB germs don't get the disease.
As a precaution, all the students at Blackburn will be tested for TB, likely with a skin test. A small amount of TB protein is injected into the skin. The injection site will harden 48 to 72 hours later if the person is infected with TB.
But JPS officials stressed that the tests are just a precaution.

THE ASSOCIATED PRESS
JACKSON - In 2006, the number of tuberculosis cases in Mississippi rose 12 percent
Previously, the disease had been declining in the state since the 1990s.
There could be several reasons for the increase, said interim State Epidemiologist Lovetta Brown.
"Since TB has such a long incubation period, it is difficult to determine a single factor as the cause of an increase or decrease in a single year. We are continuing to conduct epidemiological analysis on the cases for 2006, and the analysis is incomplete at this point," Brown said.
In the late 1980s, Mississippi's TB rate was far above the national average. In response, the Health Department used nurses to observe TB patients taking their medicine.
By the time state health officer Brian Amy took over in October 2002, Mississippi boasted one of the nation's best tuberculosis treatment programs in the United States.
In February 2003, Health Department employees facing "pressure to achieve or risk losing their jobs" had 90 days to increase from 80 percent to 95 percent the number of latent (or inactive) TB patients currently in therapy, according to a report by the Legislative Committee on Performance Evaluation and Expenditure Review.
Months later, the department said on its Web site that Amy's "new emphasis on setting goals, creating expectations and improving performance" had led to a record 98 percent of latent TB patients in therapy.
To achieve the 95 percent number, Health Department officials changed the definition of what patients were considered "current" in their therapy, said Max Arinder, PEER's executive director.
"It was a game they were playing to make themselves look better," Arinder said.
The number of latent TB patients being treated declined from 2,393 in March 2003 (when the 95 percent target was announced) to 1,861 cases nine months later, PEER found.
Amy said he asked Health Department officials for the names of any TB patients who had failed to be treated.
"Nobody knows of any case where a person was not given medicine," Amy told The Clarion-Ledger newspaper of Jackson.
Amy said he suggested doctors spend more time with latent TB patients, advising them of the risks.
"Many studies have shown if you spend a few extra minutes, the (current) rates go up," he said. "It was a valiant effort."
Getting latent TB patients to stay on medicine is difficult, he said, because they have to take the drugs for such a long period of time and patients aren't supposed to drink during the time they take the medicine.
"If you've really got TB, we make you take the medicine, by law," Amy said. "If you're just exposed (latent), you should take it."

TB Facts (taken from CDC FAQS)
http://www.cdc.gov/nchstp/tb/faqs/qa.htm

Tuberculosis (TB) is a disease caused by bacteria called Mycobacterium tuberculosis. The bacteria usually attack the lungs. But, TB bacteria can attack any part of the body such as the kidney, spine, and brain. If not treated properly, TB disease can be fatal. TB disease was once the leading cause of death in the United States.
TB is spread through the air from one person to another. The bacteria are put into the air when a person with active TB disease of the lungs or throat coughs or sneezes. People nearby may breathe in these bacteria and become infected.
(working as a paramedic, we were taught that it takes roubhly 15-20 minutes of "close" physical exposure to a person with active TB. Close meant either physically close to the person (within 3') or in a small, unventilated room. )
People with active TB disease can be treated and cured if they seek medical help. Even better, people with latent TB infection can take medicine so that they will not develop active TB disease.
Symptoms of TB depend on where in the body the TB bacteria are growing. TB bacteria usually grow in the lungs.
TB in the lungs may cause symptoms such as:
a bad cough that lasts 3 weeks or longer
pain in the chest
coughing up blood or sputum (phlegm from deep inside the lungs)
Other symptoms of active TB disease are:
weakness or fatigue
weight loss
no appetite
chills
fever
sweating at night

If you have active TB disease, you will need to take several different medicines. This is because there are many bacteria to be killed. Taking several medicines will do a better job of killing all of the bacteria and preventing them from becoming resistant to the medicines.
The most common medicines used to cure TB are
isoniazid (INH)
rifampin (RIF)
ethambutol
pyrazinamide

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