Wednesday, July 9, 2014

NYT Warns of Tuberculosis

The New York Times warns of the spread of drug-resistant tuberculosis. 
Tuberculosis rates have declined in the United States in the last decade. In 2012, there were around 10,000 cases, and of those, only 83 were resistant to all of the most commonly used tuberculosis drugs — 44 fewer than in 2011. So far we have been lucky. The low numbers hide the precarious nature of the nation’s public health defense, and how vulnerable we would be to an epidemic. 
The problem is that responsibility for tuberculosis control is divided among 2,684 state, local and tribal health departments. That infrastructure is politically and legally fragmented, underfunded and disproportionately strained in many poor communities.
Patients with infectious tuberculosis, caused by bacteria that usually attack the lungs, need medication regularly administered over many months. Local public health workers provide the medication and observe that it is taken by the patient, requiring as many as five visits each week. If treatment is interrupted, or if the drugs are not working, patients have a much higher chance of developing (and spreading) drug-resistant tuberculosis. At the same time, health workers must track down and test anyone who had come in close contact with patients before the disease was diagnosed, to be certain no one else has been infected.
All this is made much more difficult by the patchwork of jurisdictions and the lack of coordination among health departments, which can easily lose track of patients who travel or relocate to another county or state.
Even the CDC recognizes that the primary source of TB in developed countries are immigrants from poorer countries.
Migration from low/middle income countries with high tuberculosis (TB) incidence increasingly accounts for most TB cases in high-income countries with low TB incidence; the greatest risk for active TB is within the first few years of arrival. Screening for active pulmonary TB when documented immigrants enter a new country has found ≈3.5 cases per 1,000 documented immigrants. The prevalence of smear-negative cases of TB reported for US-bound immigrants and refugees was 9.6 cases per 1,000 persons.
 (End notes omitted).

So it is less than comforting to see reports indicating that the recent waive of illegal aliens are carrying various diseases, including TB. (See here). And the problem may be worse than publicly acknowledged.
However, at least a half dozen anonymous sources, including nurses and health care providers who worked at Lackland, allege that the government is covering up what they believe to be a very serious health threat. 
Several of my sources tell me that tuberculosis has become a dangerous issue at both the border and the camps. 
"The amount of tuberculosis is astonishing," one health care provider told me. "The nurses are telling us the kids are really sick. The tuberculosis is definitely there." 
Texas Department of State Health Services Commissioner David Lakey, M.D. says state health officials have seen only three cases of tuberculosis, the Associated Press reports. One of my sources with close ties to the Texas HHS tells me all three cases were reported in Austin. 
However, nurses at Lackland in San Antonio, said they know of at least four teenagers in their camp who have tuberculosis. 
"The nurses are telling us the kids are really sick," the source told me. "The tuberculosis is definitely there." 
My source said there are children showing classic tuberculosis symptoms -- spitting up blood, a constant cough and chest pain.
Fortunately we have ObamaCare (sarc.).

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