43
Mahoning TB clinic continues testing, treatment of disease
YOUNGSTOWN
Tuberculosis, still a scourge in many parts of the world and making a slight comeback in recent years in the United States, is also present in Mahoning County.
In 2016, tuberculosis disease surpassed HIV/AIDS to become the No. 1 infectious disease killer on the planet by causing more than 1.5 million human deaths annually, according to the U.S. Centers for Disease Control and Prevention’s Division of Tuberculosis Elimination.
There were no tuberculosis-caused deaths in Mahoning County in 2016, but three active cases of TB disease were recorded here that year and the Mahoning County District Board of Health’s TB Clinic works to keep the TB numbers down.
Not many years ago Mahoning and Trumbull counties each had in-patient TB clinics on Kirk Road and Squires Lane in Howland, respectively.
The Mahoning County TB facility opened in 1925, was expanded in 1936, and closed in 1973 when the number of cases dropped and local hospitals resumed treatment of TB patients.
Tuberculosis develops from TB infection, a dormant germ that cannot be detected except by testing, a service the county TB clinic provides.
Tuberculosis germs are spread through the air when a person with full-blown TB disease expels the germ by sneezing, coughing, laughing or singing. People who breathe that air may get TB infection, meaning they would have dormant TB germs in their body, according to the CDC.
Dormant germs do not make the carrier sick, and a person with TB infection cannot pass the germs to anyone else. But if the dormant TB germs wake up and multiply, the person will get sick with TB disease, a condition that can cause death if not treated with medicine.
That is where the Mahoning TB Clinic’s staff of Shawn Hunter-Little, clinic registrar, and TB nurse Denise Walters, do their work. They test individuals for the dormant TB infection and treat people with TB disease with medications.
Tuberculosis is preventable and curable, but if not treated, it is deadly, Hunter-Little said.
Since 1993, tuberculosis control in Mahoning County has been a part of the Mahoning County District Board of Health, which has collaborated with Youngstown State University since 2011 by screening high-risk students and providing treatment on campus for TB infection, Walters said.
Tuberculosis screening, evaluation and treatment is provided to county residents for both active disease and latent infection, and case management of all clients with TB is provided to ensure adherence to treatment.
The TB Clinic is supported by a five-year, one-tenth of a mill property-tax levy that generates about $176,540 per year. TB Clinic officials say support for testing programs is still very important to community health, especially with more out-of-state students attending Youngstown State University.
When a person has active TB, the TB Clinic investigates and tests others in the house or to whom the patient is otherwise close.
In order to prevent TB disease in people who have latent TB infection, they must take antibiotics daily for nine months.
“If people are unable to come to the office, we will go to their homes to test and physically monitor clients taking their medicine,” said Hunter-Little.
Many strains of tuberculosis resist the drugs most used to treat the disease. People with active tuberculosis must take several types of medications for many months to eradicate the infection and prevent development of antibiotic resistance, officials said.
In 2016, the Mahoning County TB Clinic treated 29 latent tuberculosis infection cases, three active cases of TB disease and made 342 home visits to insure adherence to treatment. Nearly 1,500 high-risk people were screened for tuberculosis.
Depending on the severity of the TB disease, patients can be placed in medical isolation or quarantined in their homes.
According to the CDC, diseases such as cholera, smallpox and the plague are very rare in the U.S., but TB disease is not going away.
In 2015 the CDC reported there were 9,563 new cases of TB disease, noting that for the first time since 1992, the number of TB disease cases rose in the nation.
The per-capita rate of tuberculosis cases has plateaued at three infections per 100,000 people.
Around 13 million Americans have latent TB infection, approximately 5 to 10 percent of whom will develop the active, infectious form of the disease at some point in their lifetime. That means as many as 1.3 million Americans could become infectious if not treated, according to the CDC.
The symptoms of active TB disease include wracking coughs, night sweats and debilitating fatigue. Victims can’t stop losing weight, and they feel as if they can’t breathe.
According to the Mayo Clinic in Minnesota, TB mainly affects the lungs, but can also attack other parts of the body. For example, TB of the spine may cause back pain, and TB in the kidneys might cause blood in the urine.
Once rare in developed countries, tuberculosis infections began increasing in 1985, partly because of the emergence of HIV, the virus that causes AIDS and weakens a person’s immune system so it can’t fight the TB germs as effectively.
In the U.S., because of stronger control programs, tuberculosis began to decrease again in 1993, but remains a concern.