TB Cases at 25-Year Low

The latest statistical data collected by the Houston Department of Health and Human Services reveals that new tuberculosis cases in Houston and Harris County declined in 2000 to the lowest level since 1975.

The data shows that new tuberculosis cases totaled 403, almost a 50 percent reduction since 1995.

"Although TB rates are declining in Houston and the rest of the country, we must continue our rigorous vigilance," said Marcos Longoria, bureau chief with the department's Tuberculosis Control program. "Tuberculosis continues to be a major public health problem and a single case has the potential to become an outbreak if not promptly recognized and treated."

TB is an airborne disease caused by the Mycobacterium tuberculosis bacteria, which can attack any part of the human body but usually accumulates in the lungs. It is transmitted from one person to another when someone with TB disease of the lungs or throat either coughs or sneezes and people nearby inhale the bacteria and become infected. People with TB are most likely to infect others that they are in close contact with every day in confined spaces. They include family members, friends and occasionally coworkers.

People with TB infection have no symptoms, don't feel sick and can't spread TB to others because the bacteria remain inactive. However, they may develop the disease later in life. With preventive therapy, they are unlikely to develop the disease.

TB disease develops when the infected person's immune system can't contain the germs' growth. Although the initial infection is usually in the lungs, the bacteria can move through the blood to different parts of the body such as the kidney, spine and brain.

TB symptoms depend on where in the body the bacteria are growing. TB in the lungs may cause a bad cough that lasts longer than two weeks, pain in the chest and coughing up blood or sputum (phlegm from deep inside the lungs). Other symptoms of TB include weakness or fatigue, weight loss, loss of appetite, chills, fever and night sweats.

The disease can almost always be cured with medicine. The bacteria die slowly. To ensure all are killed, the treatment calls for taking several different drugs for at least six months.

People who don't take the medicine regularly, or who stop taking it when they begin feeling better after a few weeks, put themselves and family and friends in a dangerous situation. The bacteria may begin to grow again, causing those with the disease to again become infectious, making them sick for an even longer time period and vulnerable to multi-drug resistant TB disease. It is more difficult to treat multi-drug resistant TB because patients may need new, different drugs to kill the bacteria if the old drugs no longer work. These new drugs have to be taken for a longer time and usually have more serious side effects.

Last year, the Tuberculosis Control program at the Houston Department of Health and Human Services provided 1,798 people with directly observed therapy, an intervention where field staff deliver medication to a patient's home, work or school several times a week, monitor for side effects and observe the patient taking the drugs.

Children are most susceptible to diseases from birth to age 2, therefore, they also run a higher risk that the bacteria may become active and cause TB disease. People with HIV, the virus that causes AIDS, also are at a higher risk because they have extremely weak immune systems. Others at risk for TB, are those who are sick with other diseases that weaken the immune system.

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©2006 Texas Medical Center

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