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October 9, 2007 > Tuberculosis: Still a Significant Public Health Concern

Tuberculosis: Still a Significant Public Health Concern

Specialist Sheds Light on TB and Other Respiratory Diseases

Tuberculosis. It seems like one of those long-forgotten diseases - such as polio or smallpox - that have almost faded into obscurity in this country. And true enough, tuberculosis, also known as TB, began declining in the United States after the development of advanced medical therapies in the 1950s. But before that point, TB was the most common cause of death in the United States, according to Dr. Jason Chu, Medical Director for Pulmonary Rehab and Respiratory care at Washington Hospital.
Named after the bacterium tubercle bacillus, TB is a serious and infectious disease that usually attacks the lungs but can attack almost any part of the body.
Awareness remains vital
Since the 1950s, TB continued to decline until the rise of the AIDS epidemic during the 1980s and 90s, Dr. Chu explains. While TB has begun to decline again in the United States, it still remains a major public health concern, according to Chu.
To promote the importance of awareness about TB, Dr. Chu will present a free Health & Wellness seminar focusing on TB and other major respiratory illnesses.
Referred to as a "global burden," there are an estimated 13,000 cases in the United States per year - with cases in California alone representing a sixth of that total number, according to Dr. Chu.
"Fremont certainly gets its share of TB infections with 17 percent of the total caseload for Alameda County behind Oakland, which accounts for 40 percent," he says.
A majority of TB cases in the United States, according to Dr. Chu, originate from foreign-born patients that come from TB endemic regions, such as the Philippines and Vietnam. The racial distribution of TB infections, he says, is: 60 percent Asian Pacific Islander; 14 percent Latino; 20 percent African American; and 5 to 7 percent White.
The necessity for close follow-up
"We're far from a cure like smallpox, which has been virtually wiped out," Dr. Chu says. "Patients need to be treated and treatment requires follow-up. The difficulty is that treatment for TB is very different than your typical week-long course of antibiotics. To be effective, treatment actually requires a nine-month course of antibiotics. When patients do not receive an adequate treatment course it creates the potential for a mutated drug-resistant strain of the disease."
Dr. Chu calls TB a "complicated" disease, which is usually contracted by inhaling airborne bacterial pathogens from a person in close proximity. Patients typically do not appear as acutely ill as they would with pneumonia, but may have symptoms including lingering cough, malaise, a feeling of being run-down, as well as low-grade fever.
"TB is often initially treated like pneumonia or bronchitis, but then it resurfaces," he says. "The disease is highly infectious and transmittable, making it a huge public health concern."
While 70 to 75 percent of TB infections typically affect the lungs, Dr. Chu says the infection also can spread to involve other parts of the body, such as bones, joints, and the brain, and can lead to death.
Even though TB comes close to being as common as pneumonia, very few people are even aware that they have been infected, and many do not realize the extent of the dangers of infection to themselves and others, Dr. Chu says. He cites the recent example of the attorney from Atlanta, Ga. who knew he had a strain of TB but still traveled on several international flights, potentially exposing thousands of unknowing fellow passengers. This case and others underscore the importance of improving health care practitioners' tracking and follow-up of infectious patients, according to Chu.
Prevention requires vigilance
Effective prevention of TB often begins in the workplace, he notes. Employee awareness and vigilance by human resources departments can go a long way towards preventing an outbreak.
"To hopefully prevent the spread of TB, there needs to be access in the workplace to skin testing," he says. "Employees should be on the alert if they are at all concerned and not ignore signs of potential infection. Additionally, people must be cognizant of respiratory symptoms that persist longer than the regular cold, bronchitis or flu, because there's a chance they may have been exposed, and therefore should receive a chest X-ray or sputum tests to rule out TB infection. Controlling TB requires common sense on the part of patients and advocacy on the part of HR departments in the workplace."
Overall, vigilance and improved tracking of patients are keys to controlling the disease, according to Dr. Chu.
"This is a very global society we live in now," he says. "In this economically competitive day and age people need to be accepting of that fact and be aware that because the world is becoming closer, it predisposes people to the No. 1 or 2 disease entities that cause hospitalizations, economic impact, time off work and even death in other countries."
Dr. Chu's seminar will also briefly cover respiratory illnesses such as asthma, chronic obstructive pulmonary disease (COPD) and chronic bronchitis, and how to recognize respiratory illnesses early to avoid letting them progress into pneumonia.
Learn about tuberculosis from an expert
To hear more about TB and other respiratory illnesses from Dr. Chu, plan on attending the Health & Wellness seminar, "Tuberculosis and Respiratory Diseases: What You Need to Know," on Tuesday, Oct. 16, from 1 to 2:30 p.m. at the Conrad E. Anderson, M.D. Auditorium, Rooms A & B, located at 2500 Mowry Ave., Fremont.
To register for the seminar, call (800) 963-7070.
For more information about upcoming classes and seminars at Washington Hospital, visit www.whhs.com, click on "The Community," and select "Community Seminars & Health Classes " from the drop-down menu.

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WHAT: Tuberculosis and Respiratory Diseases: What You Need to Know
WHEN: Tuesday, Oct. 16, 1 to 2:30 p.m.
WHERE: 2500 Mowry Ave., Fremont, Conrad E. Anderson, M.D. Auditorium, Rooms A & B,
CALL: (800) 963-7070 to register

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