By Shelley Byrne sbyrne@paducahsun.com--270.575.8667
Wednesday, July 06, 2005
Tuberculosis cases are declining in Kentucky and Illinois, but cases in jails and prisons remain a problem, according to the Kentucky Tuberculosis Control Program.
Each year, between 700 and 1,000 cases of tuberculosis are reported nationwide among residents of correctional facilities, according to the program's Web site.
The homeless, drug abusers and people who live in nursing homes are also at greater risk.
Of 138 people in Kentucky diagnosed with tuberculosis in 2003, the last year for which detailed information is available, six lived in long-term care facilities, seven had been homeless within a year of their diagnosis, and three were housed in correctional facilities.
The problem often starts in other countries. Of those diagnosed in Kentucky, 29 were born outside the United States. In Illinois, nearly 40 percent of cases were among people born in foreign countries, according to the Illinois Department of Public Health.
The Kentucky Tuberculosis Control Program monitors physicians' progress in eradicating the disease by calculating case rates, the number of instances of tuberculosis per 100,000 people.
In Kentucky, case rates have declined each year, from 9.2 in 1994 to 3.1 in 2004.
Part of the reason is the vigilance of healthcare workers at the regional level, said Dr. Kraig Humbaugh, director of the state Division of Epidemiology and Health Planning.
"Kentucky used to be in the top 25 of the 50 states in TB cases," Humbaugh said. "Now for the last few years, we've been in the bottom half."
In western Kentucky, seven cases were reported in 2003. Of those, two were in Ballard County, two in Calloway County, two in Graves County and one in Livingston County. Last year, only two cases were reported in the region: one in Ballard County and one in Livingston County.
Illinois had a record low number of cases last year — 569, according to the Illinois Department of Public Health. Of those, 505 were in the city of Chicago or the surrounding counties of Cook, DuPage, Kane, Lake, McHenry and Will. Illinois cases have been decreasing each year since 1996.
"This continuing decline in cases is encouraging, but we must remain vigilant," said Dr. Eric Whitaker, Illinois public health director. "Tuberculosis is still a significant health threat, and the public health and medical communities must maintain the ongoing efforts to better identify and treat people with infectious tuberculosis."
Although potentially life-threatening, tuberculosis is usually curable. However, a person with the disease must take three or four drugs faithfully for six months or more.
One strategy both Kentucky and Illinois have used to reduce their cases is "directly observed therapy," during which public health workers monitor tuberculosis patients to make sure they take the correct drugs consistently.
Progress in eliminating the disease is becoming more difficult, Humbaugh said. "I think it's a challenge for our program because as we're seeing cases decrease, we're also seeing our federal funding decreased."