County TB rate bucks trend, remains high

Tuberculosis cases in Santa Clara County are the third highest in the state and remain high despite a large drop in the rest of the state, according to a report released Monday by The Tuberculosis Prevention Partnership of Santa Clara County.

While the number of tuberculosis cases in California dropped significantly in 2009, Santa Clara County had 197 cases in 2009, the same as in 2008, according to the report.

The tuberculosis rate in California was 6.4 cases per 100,000 people, while the case rate in Santa Clara County was 10.8 cases per 100,000 in 2009. Nationwide, the tuberculosis rate was 3.8 cases per 100,000 people in 2009.

“TB is still a serious problem in Santa Clara County,” Santa Clara County Health Officer Marty Fenstersheib said.

“The public and private sector can eliminate TB if we work together to find and treat people with TB and focus on prevention efforts. An important part of prevention is effectively screening and treating latent TB infection in people with chronic diseases like diabetes, which makes people more susceptible to developing active TB,” he said.

Tuberculosis is a bacterial lung disease that can remain dormant in infected individuals for years. Persons infected with TB often aren’t aware of the disease because their infection is “latent” or inactive and doesn’t make them or others sick. When the infection becomes active, the infected individual is contagious.

People with latent TB need to be treated to prevent the progression to active TB. Inappropriate or incomplete drug therapy by those with active TB can lead to multi-drug resistant (MDR) TB, county officials said.

“Even in these tough times, we need to make sure we maintain adequate funding for TB programs,” said Margo Sidener, president and CEO of Breathe California of the Bay Area.

“To prevent a resurgence of TB as we saw in the 1980s when funding was cut, we need to continue to identify and treat individuals with latent TB before they develop active TB and spread the disease to others.

“We also need to make sure people take their full course of medication to prevent the spread of MDR TB. All this takes resources, and if we don’t commit them now, we will pay much more in the future,” she said.

Tuberculosis is a global health issue, with one third of the word’s population infected, according to the Centers for Disease Control and Prevention.

Each year, nearly 2 million TB deaths occur worldwide. The Bay Area, including Santa Clara County, is home to many people who frequently travel to and from areas around the world with high TB rates, increasing the risk for TB here, county officials said.

The Santa Clara County Public Health Department works with local health care providers to stop the transmission of TB by identifying cases and following them through the completion of therapy.

When an active case is identified, persons who have come in close contact with the infected individual must be evaluated and screened for TB.

The public health department conducts about 1,250 contact investigations annually. About one-third of persons who have been in close contact with someone who has active TB become infected with latent TB (the non-contagious form) and 1 percent of those contacts are diagnosed with active TB, county officials said.

“We are calling on all elected and appointed officials — locally, statewide and nationally — to stay the course and resist decreasing funds for TB control at this critical time,” Sidener said. “Only if this is done will Santa Clara County and other high-rate counties be able to see a decrease in tuberculosis.”

On Monday, Rachel Orduno, a TB survivor, spoke about the role in stopping the spread of TB. It’s imperative that people with TB complete their full course of treatment, which can take six months or more, she said. Orduno had latent TB and within a year of being diagnosed with diabetes, her latent TB turned into active TB, she said.

The announcement was made at Cisco LifeConnections Health Center, which is located on the Cisco campus and provides comprehensive health care services to its employees. Cisco has worked closely with the Santa Clara County Public Health Department to fight TB.