Tuberculosis still a cause for concern in East Bay

Published by Contra Costa Times

Posted on Sat, Mar. 20, 2004

By Dr. Charles M. Crane

WHEN YOU HAVE a persistent cough, like most people, you probably try home remedies before seeing a doctor.

You might suck on cough drops, gulp cough medicine, get plenty of rest and drink herbal tea. Most of the time, the cough goes away. But sometimes the problem is much more serious - tuberculosis.

Most people think they are not at risk for TB, but that may not be true. Since World TB Day is Wednesday, it's a good time to join the World Health Organization in becoming aware of the threat posed by this disease, which kills 2 million people around the world every year. This is more than any other infectious disease.

TB is still something to worry about in Contra Costa County. Anyone who was born in or travels to a country with a high TB rate is at risk. But even people who never leave the United States can get TB. Doctors, nurses, police, firefighters and correctional officers are at increased risk from contact with TB patients.People who live in three ZIP codes in West County (94801, 94804 and 94806), where the TB rate is high, are at even higher risk. Others at risk include homeless people, those who have been incarcerated and drug users.Patients with diabetes, cancer or AIDS are also vulnerable because of their weakened immune systems.

Symptoms of active TB disease typically include a cough with phlegm lasting at least three weeks, accompanied by fever, night sweats, fatigue and weight loss of at least 10 pounds. If you have these symptoms, see a doctor right away and mention the possibility of TB.

Many people with TB don't seek care, often because they don't realize how long they've been sick or how sick they have become. A delayed TB diagnosis can lead to serious illness or death. In addition, it will expose others, often family members, sometimes leading to a recurring cycle of infection and transmission. When diagnosed promptly, however, TB is curable with a simple combination of medicines, taken for six to nine months.

TB is transmitted through the air when a patient with active TB disease coughs. Most people who contract the TB germ never get sick from it and are not infectious. They have "latent" TB infection. They carry the germ and are at risk for developing active TB disease in the future, but they have no symptoms.

They usually don't know they were exposed, because the person who exposed them didn't know he or she had TB.

People who are at risk can get a simple, inexpensive TB skin test (or TST, also called a PPD) to see if they have latent TB infection. If they do, they can be treated with a medication called isoniazid (or INH) for six to nine months so they will not get active TB disease.

People without a regular doctor or health insurance can call Contra Costa Public Health toll-free at 877-405-8573 to find out where to get a TB skin test. To see a doctor at Contra Costa Regional Medical Center and clinics, call 800-495-8885. A financial counselor will assist you in applying for financial coverage and making an appointment.

Dr. Crane is the medical director of the tuberculosis program, Contra Costa Health Services.