TUBERCULOSIS: Statewide Case Load Stats Continue Seven-Year Decline
Continuing a seven-year trend, California's rate of new tuberculosis cases dropped by 6% since last year, the AP/Contra Costa Times reports. Since a 1992 surge in TB infections, the number of new cases has dropped 33% statewide, according to the state Department of Health Services. Officials attribute the consistent decline to the state's multipronged attack on the disease. Dr. Sarah Royce, chief of the health department's TB control branch, said the agency has improved infection control efforts, especially in institutions and homeless shelters, and has "stepped up investigations" of infection sources. Health workers also have employed a strategy to observe patients taking TB medication -- a measure to ensure treatment compliance and prevent further development of "multi-drug resistant TB." More than 15% of TB cases are resistant to at least one common form of therapy and 1%-2% are resistant to the most powerful drugs. Despite these control efforts, California last year led the nation in the total number of TB cases, primarily due to the state's large immigrant population. Roughly 10% of Californians are infected with TB bacteria -- a person has a 5% risk of progressing from infection to active TB. State health officials report that 70% of TB patients are foreign-born. Warning that TB remains a "serious public health threat in the state," Royce said, "If we let down our public health defenses, we'll see our gains reversed" (Lindlaw, 3/22).
Among California's counties, Los Angeles County had the highest number of TB cases last year, at 1,170. But this figure represents a drop of 9.9% since 1998. San Diego County came in second with 296 cases, a decrease of 12.7% from two years ago. San Joaquin County reported the fewest cases, with only 74. The greatest improvement was seen in Orange County, which saw a case reduction of 17.4%. Bucking the overall negative trend, San Francisco County experienced the highest case increase, with a 13.5% jump (AP/San Diego Union-Tribune, 3/22).