TB rates down

Health officials across the globe thought they had a handle on the spread of tuberculosis, but a new report from the World Health Organization this week expresses fears of an increase.

That fear is real to Dr. Joseph Iser, Nevada County's Public Health Department director, who recently gave the Board of Supervisors an update on the county's readiness for TB, which killed 1.5 million internationally in 2006, the last year recorded by WHO.

Nevada County actually had no new active cases last year of the disease that usually attacks the lungs. A spike of 13 discovered cases in Placer County is what caught Iser's attention and means two things.

"It means we're not finding (cases), but we are likely to get an increase in the next couple of year because of the interaction" with Placer County, Iser said. "TB is one of those diseases that hides itself."

Nevada County only had two new cases of TB in 2005 to Placer's five. Nevada County had two new cases again in 2006 to Placer's six.

The slight creep in cases next door was somewhat expected, Iser said, because of "our mobile society and people bringing it in from other countries."

WHO's report released Monday said that while world TB cases have decreased in recent decades, the rate of decrease is slowing because of a new drug-resistant strain and its interaction with HIV.

The new multi-drug resistant tuberculosis reached the highest levels ever recorded in February, and the world is only ready to deal with 10 percent of the cases, WHO said. About 500,000 of the drug-resistant cases are occurring every year.

Compounding the situation is that HIV is causing more people to have compromised immune systems, which can't protect them against TB, particularly in Africa.

Last year 52 people tested positive for TB in Nevada County, and seven are being treated with medication to stop their latent infection stage from turning into the active form of TB that makes them sick, Iser said. There have been no drug-resistant patients discovered here yet, he added.

Testing positive only means you have "the bacteria that has been around since antiquity," Iser said. "About 10 percent who have tested positive come down with (active TB) their during their lifetime," and actually get ill.



Hospital ready

Sierra Nevada Memorial Hospital did not have any TB cases in 2007 but has had a few in recent years, according to Allan Finlay, the hospital's infection control practitioner. When TB does show up, the hospital is more than ready.

"We have a special kind of isolation called airborne isolation," Finlay said, that could be used for any outbreak of commmunicable disease.

In eight different rooms, the pressure is sucked out into an independent ventilation system so that germs aren't released into the hall. There are also two portable systems that can pressurize the rooms for the same purpose.

Incoming patients are tested for TB, as are hospital employees, Finlay said.

"Any nurse or person who cares for a TB patient gets a special mask that filters the TB bacteria," Finlay said.

Both Finlay and Iser said TB thrives in close quarters, which is why public health officials are always on the lookout for it in jails, prisons, care homes and military barracks.

At risk?

Those with weakened or compromised immune systems are most at risk for TB, according to the national Centers for Disease Control. They include the elderly; children 10 and under; thin people; substance abusers; and sufferers of diabetes, leukemia, cancer of the head or neck or Hodgkin's disease.

Symptoms of TB include a bad cough that lasts longer than three weeks, chest pain and coughing up blood or sputum from deep inside the lungs. Other less intense symptoms include fatigue or weakness, weight loss, fever, night sweats and weight and appetite loss.

The disease is spread by the droplets in people's coughs and sneezes breathed in by others.

To get tested for TB in honor of World TB Day, which is Monday, you can get a skin test by calling the county health department at 265-1450 to set up an appointment. The county asks for a $10 donation for the test, Iser said.

The county's doctor also said he has the authority to quarantine TB patients if they refuse treatment but would do so only as a last resort.

To contact Senior Staff Writer Dave Moller, e-mail dmoller@theunion.com or call 477-4237.



New active TB cases

n 2005

Placer County................5

Nevada County..............2



n 2006

Placer County................6

Nevada County..............2



n 2007

Placer County..............13

Nevada County..............0