Tomorrow is World Tuberculosis Day, which marks the day in 1882 when microbiologist Robert Koch announced he had discovered the bacteria that causes tuberculosis. More than two billion people – one third of the world’s population – are infected with tuberculosis.
In Westchester, the county health department closely monitors tuberculosis. In 2011, 38 Westchester residents had tuberculosis, on par with the 37 cases in 2010. Although the number was relatively stable, the county’s most recent cases have been much more complex, either due to drug resistance or because of the settings where the cases occurred and the numbers of people exposed.
“A simple skin test can determine whether you have been exposed to TB,” said Dr. Sherlita Amler, Commissioner of Health. “I encourage everyone to talk to their doctor about this test, to see if they would benefit from having one. With treatment, a person’s chances of a full recovery are quite good.”
In New York State, Westchester County had the 2nd highest number of residents with TB and, along with Putnam County, the highest case rate of TB outside New York City in 2011. Westchester residents diagnosed with TB come from a diverse range of ethnic, racial and socioeconomic backgrounds and have included young children and students, retail store and restaurant workers, housekeepers and people employed in schools and in health care.
Of growing concern in Westchester County are cases of multi-drug resistant TB (MDR-TB), which can occur when people do not complete their full course of treatment. An individual with MDR-TB can spread the infection to others. People with MDR-TB require a more extensive medication regimen and follow-up medical management. They must be actively treated for about two years and must be monitored for another two years afterwards. To date, there are eight cases of MDR-TB in Westchester that the health department is managing.
Through its TB clinics, the Westchester County Department of Health provides free medical care and medications to residents with active TB. The Health Department also follows up with residents with active TB being managed by other healthcare providers in the County to ensure that all patients are appropriately treated to decrease the likelihood of spreading the infection to others.
The Health Department makes sure that individuals with active TB do not go to work, attend school or go to other places where they may spread the infection to others and also conducts directly observed therapy to ensure that individuals with TB are compliant with their medications. In 2011, Health Department staff made nearly 4,800 visits to patients with tuberculosis to observe them taking their medications and to provide additional education to prevent disease transmission.
People exposed to individuals with active TB also require special management and treatment. To date, for TB cases identified during 2011, the Health Department was involved in 28 contact investigations through which approximately 187 people potentially exposed to an infectious TB case at workplaces, schools, and healthcare facilities were identified in need of evaluation. In addition, 167 household, close, social and other individuals exposed to active TB cases were evaluated.
One in 10 of those infected will become sick with active TB in his or her lifetime, according to the World Health Organization. If untreated, each person with active TB can infect, on average, 10 to 15 people a year. In New York State, 910 cases of TB were reported in 2011, a 4.6 percent decrease from 954 cases in 2010.
Tuberculosis is a disease caused by a bacterium that is usually spread when an infected person coughs. TB usually infects the lungs, but it can also affect other parts of the body. Symptoms can include weakness, fatigue, nausea, weight loss, fever and night sweats. Persistent coughing, chest pain or coughing up blood might be symptoms of TB of the lungs. If left untreated, TB can be fatal.
Because TB is relatively uncommon in the U.S., there is often a delay in diagnosing and treating the disease. During this delay, the infection can spread to others. People who are exposed to someone with active
Tuberculosis generally do not become ill immediately. This stage is called latent infection and it could take months or years before the infection spreads inside the body and causes illness (active TB). If treated during the early stages, such illness can be avoided.
For more information about tuberculosis, call the Westchester County Department of Health at (914) 813-5000 or visit the Health Department website.
