TN Sees fewer "TB" cases, but case complexity is more difficult than ever

Mar 18, 2014 at 11:53 am by bryan


The number of confirmed cases of tuberculosis, one of the world’s oldest and deadliest diseases, reached a historic low in Tennessee in 2013. However, many TB cases seen in Tennessee in recent years are complex and more challenging for health care providers to treat. As part of the observances of World TB Day March 24, TDH is working to remind Tennesseans that TB is a significant public health concern.

“When our department was created in 1923, tuberculosis was by far the leading cause of death in Tennessee,” said TDH Commissioner John Dreyzehner, MD, MPH. “Today, thanks to the constant efforts of public health and clinical professionals it is rare here, but constant vigilance is required to keep it from resurging. TB still kills 1.4 million people a year worldwide, and with multi-drug resistant and extremely drug resistant forms on the rise we must continue to be vigilant. It is not, unfortunately, unthinkable that this disease could again become a more common killer here as it is in too many places abroad.”

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“Many of the individuals we have identified in Tennessee with active TB and treated in recent years have other medical conditions that need to be controlled in order to make the TB treatment more effective,” said Jon Warkentin, MD, MPH, State TB Control Officer and medical director of the Tennessee Tuberculosis Elimination Program. “We want to raise awareness that TB is treatable, curable and preventable.”

You can receive a TB test at the Rutherford County Health Department offices in Murfreesboro and Smyrna if you feel like you have been exposed to tuberculosis. 

Special Event for Physicians: 

Tennessee’s TB Elimination Program is hosting a special educational event for physicians on April 2, 2014 in Nashville. The 2014 World TB Day Symposium:  New Challenges and New Tools in the Diagnosis and Management of Tuberculosis will include medical information from TB experts with the new Vanderbilt Tuberculosis Center, the Southeastern National TB Center and the Tennessee TB Elimination Program.

“This symposium, which we hope will be the first of many annual World TB Day educational offerings, will engage participants through presentations of actual TB cases in Tennessee, analysis of clinical challenges and opportunities by a panel of clinical and laboratory experts, lectures and participant discussions,” said Warkentin.

In 2013, 143 cases of TB were reported in Tennessee, a decrease of 12.8 percent from 2012 and the lowest number of TB cases in one year in the state’s recorded history. There were 101 Tennessee adults and children undergoing treatment for suspected or confirmed active TB disease as of Jan. 1, 2014, and another 980 patients in treatment for TB infection.

The global TB epidemic continues to be a leading cause of death and illness, with nearly nine million new cases and 1.4 million TB-related deaths annually worldwide. The Centers for Disease Control and Prevention reports one third of the world’s population is currently infected with TB germs and bears the risk of developing active TB disease.

TB is spread through the air from one person to another when a person with active TB disease of the lungs or throat coughs, sneezes, speaks or sings. Symptoms of TB in the lungs may include a persistent cough for three or more weeks, chest pain and coughing up blood. Other symptoms of active TB include loss of appetite, weakness, unexpected weight loss, fever and drenching night sweats. TB usually affects the lungs, but can also affect other parts of the body such as the brain, kidneys or spine. If active TB is not treated quickly and appropriately, the disease can be fatal.

A skin or blood test can determine if an individual is infected with TB bacteria. When this occurs other tests are needed to determine if he or she has TB disease. These may include medical history, physical examination, chest X-ray and other laboratory tests.

TB bacteria can live in the body without making a person sick, a condition called “latent TB infection.” People with TB infection cannot spread TB bacteria to others. Treatment is available to prevent the infection from progressing to cause active TB disease in the future.

TDH recommends those at high risk for TB have a skin or blood test to find out if they are infected with TB. Persons at high risk for TB include those born in countries with high rates of TB; individuals infected with HIV and AIDS; homeless individuals; people who have spent time in jail or prison; intravenous drug users and those who have had close interactions with someone with infectious TB disease.

Source and Information:

All Tennessee county health departments offer free TB risk screening and confidential testing and treatment for those at high risk for infection. Find a list of local health departments online at http://health.state.tn.us/localdepartments.htm or call the toll-free Tennessee Anytime Help Desk toll-free at 866-8TN-EGOV (866-886-3468).

Learn more about TB in Tennessee on the TDH website at http://health.state.tn.us/ceds/TB/facts.htm.

Physicians seeking more information about the World TB Day Symposium may contact Trudy Stein-Hart at 615-532-8505 or Trudy.Stein-Hart@tn.gov.

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