Worst TB outbreak in 20 years kept secret (Florida)

[Liberal_in_LA]

Source: Palm beach Post

JACKSONVILLE —


The CDC officer had a serious warning for Florida health officials in April: A tuberculosis outbreak in Jacksonville was one of the worst his group had investigated in 20 years. Linked to 13 deaths and 99 illnesses, including six children, it would require concerted action to stop.

That report had been penned on April 5, exactly nine days after Florida Gov. Rick Scott signed the bill that shrank the Department of Health and required the closure of the A.G. Holley State Hospital in Lantana, where tough tuberculosis cases have been treated for more than 60 years.

As health officials in Tallahassee turned their focus to restructuring, Dr. Robert Luo’s 25-page report describing Jacksonville’s outbreak — and the measures needed to contain it – went unseen by key decision makers around the state. At the health agency, an order went out that the TB hospital must be closed six months ahead of schedule.

Had they seen the letter, decision makers would have learned that 3,000 people in the past two years may have had close contact with contagious people at Jacksonville’s homeless shelters, an outpatient mental health clinic and area jails. Yet only 253 people had been found and evaluated for TB infection, meaning Florida’s outbreak was, and is, far from contained.


Read more: http://www.palmbeachpost.com/news/news/worst-tb-outbreakin-20-years-kept-secret/nPpLs/

[yardwork]

1. Inexcusable.

[Omaha Steve]

2. Did Creighton med student spread TB to patients? (student was in residency 100's to be tested))

http://www.omaha.com/article/20120706/LIVEWELL01/707069948#did-creighton-med-student-spread-tb-to-patients

Published Saturday July 7, 2012

By Roger Buddenberg

Tuberculosis diagnosed about a month ago in a Creighton University medical student will mean tests this summer for hundreds of patients and staff at the VA Medical Center, where the student was in residency — and for a few dozen at Creighton University Medical Center, where the student did rounds, said officials at the two hospitals.

TB is relatively rare and declining in the United States, rarer still in this part of the country, and very unusual among health care workers, said Dr. Ann O'Keefe, epidemiologist with the Douglas County Health Department, which is coordinating with the two hospitals.

Over the past decade, the department has reported about 10 TB cases a year to the Centers for Disease Control and Prevention. O'Keefe couldn't recall any previous diagnosis in a Nebraska health worker. “It's pretty rare.”

It's not known how the Creighton student, who wasn't identified, contracted the disease, a bacterial infection of the lungs, hospital officials said. Creighton med center staff are screened for it annually, said spokeswoman Kelsey Archer.

FULL story at link.

[L0oniX]

3. This may only be the begining of this sort of thing...

and of course would be accelerated should more sociopath GOP obtain office.

[raccoon]

26. And quite likely TPTB would try to hush it up. Imagine that. nt

[DBoon]

4. They are busy trying to return us to the late 19th century

including the contagious diseases common them.

It was the Progressive reforms that resulted in a public health system that could contain and roll back some of the great scourges of mankind.

The same Progressives that the right wing demonize

[coalition_unwilling]

35. Forget the late 19th Century, think 14th Century and black death (which killed 1/3

of the population of Europe and Central Asia).

[libodem]

5. OMG

So tragic and such misguided policy.

[byeya]

6. This is a predicted consequence of allowing essential public health services to

wither on the vine.
The ultra-rich are at risk too because they employ many day laborers at their estates and TB is readily passed from person to person via the air.
Drug resistant TB is very common is Juarez just across the river from El Paso.

[UnrepentantLiberal]

7. This is you're government shrunk to the size of a bathtub

at work.

[russspeakeasy]

8. Even for a thief like scott, this is crazy.

[Warpy]

9. These people think the only function of government is defense.

In state governments, this means police to keep the poor controlled.

If justice were reality instead of a cruel fantasy, pRick Scott would be an early victim of this outbreak because learning first hand why public health departments and tuberculosis wards exist is the only way they will ever learn.

[dixiegrrrrl]

14. kinda makes ya want to cough in his face, doesn't it?

[Warpy]

20. Oh, if there was an off chance I had TB

I might pay the air fare to Florida (masked in the plane, of course) and go to a meet and greet just for the opportunity.

[coalition_unwilling]

36. As evil a MoFo as Scott unquestionably is, you don't wish TB on anyone really. It's

a horrible way to die.

[Warpy]

40. Well, most of it is still treatable

but thinking of him confined for a month or two while the drugs kick in and having to continue those drugs (which can have bad side effects) for a year is comforting. I think it would teach him a very useful lesson in why the rich need to make sure the "diseases of the poor" are taken care of in a timely manner.

[drm604]

44. This is defense.

I don't know why they can't see that. Infectious disease, especially when it's drug resistant, can be a threat to our economic and physical well-being just like a foreign enemy can be. In fact, a foreign enemy can use infectious diseases as a weapon.

Protection against things like this can be just as important as protection against guns and bombs. They'll spend any amount of money, and incur any amount of debt, for other forms of defense; but defense against microbes? "Hey, leave that to the private sector, the government doesn't have the money for that!"

[Baitball Blogger]

10. Florida was ripe for this kind of thing.

These people don't take government work seriously. Leaders just want to make life cushy for themselves and dump on everyone else.

Again, Florida will need to be bailed out by Federal money.

[patrice]

11. His Rickness closed the hospital, because he needs that money to save some TIF'd real estate...?

[Mojorabbit]

12. I bet it was withheld so the hospital would be closed without any questions. nt

[mrmpa]

13. Totally inexcusable...........

my Uncle died of TB in 1949. I never met him. Mom describes the most horrible disease and my Uncle's wasting away. We have the means to contain it and control it. WTF is wrong with "decision" makers?

[glinda]

16. uh...this is in Florida....

[mrmpa]

18. I know it's in Florida.............

something that can be taken care of today, so that we don't have the ravages of the disease that were prevalent in the past is inexcusable.

[NOLALady]

32. My Mother died at 23

March, 1949 of TB. They didn't know how to treat it, just kept cutting out pieces of her lungs.

I was exposed to it on a job. I was the only staff member who tested positive on the next annual check up. I was treated for a year.

This is scary stuff, especially since our genius Governor has stamped a death sentence on Louisianians who need the ACA.

[mrmpa]

53. Sorry about the loss of your Mom............

I know how the scare lingers. In the '70's for a couple of jobs I had to have a lung x-ray, looking to see if there were signs of TB. My mom cringed until the results came in.

These governors need to be put out of my misery.

[lonestarnot]

15. OMG!

[BumRushDaShow]

17. I remember when this happend in NYC

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1113831/

Similar issues -

The causes were multifactorial but three are worth highlighting. Firstly, funding for tuberculosis control from the federal and state governments and the city had been slashed in the 1970s and had not recovered as rates had risen. Secondly, the city’s Bureau of Tuberculosis Control suffered substantial internal problems, resulting in poor communication between inpatient facilities and community and outpatient services.5 Finally, through the 1980s the city had undergone major social upheavals. Neighbourhoods, particularly poor ones, were transformed by increases in overcrowding, inequality, homelessness, and the spread of HIV. The fracturing of communities both fanned the flames of the epidemic and made it much harder to encourage people with tuberculosis to adhere to treatment.6,7

It's like history repeating itself in another part of the country.

[still_one]

19. I wonder what the FLoridians feel about their elected officials they voted in? /nt

[Kablooie]

21. Two people I know died of TB in the last few years.

[CoffeeCat]

22. Aren't most of us innoculated

...against TB? Isn't TB one of the diseases covered in standard innoculations? Most of us got them as children and most kids gets these shots.

Why would TB still be a threat then, and why would many contract it today and die from it if TB is included in today's innoculations?

[madrchsod]

24. it`s mutating...

cailifornia and florida have been fighting this new strain for several years.

http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=0CFAQFjAA&url=http%3A%2F%2Fwww.msnbc.msn.com%2Fid%2F34516639%2Fns%2Fhealth-infectious_diseases%2Ft%2Fdanger-home-rare-form-tb-comes-us%2F&ei=Gbj6T-vCFce62wWWsNGxAg&usg=AFQjCNE2BkfSpsSNjtyQ0WIId2K14RtOoQ&sig2=S1BJkYH52IOGY1jw6ElDBQ


tb has been traced back at least 9000 yrs

[CoffeeCat]

25. Thanks for the info

...and also for the links. That is quite frightening.

[coalition_unwilling]

51. I don't see how that's possible, since the earth is only

6,000 years old (JK!

[Sgent]

28. Nope

its not routine: http://www.cdc.gov/vaccines/schedules/downloads/child/0-18yrs-11x17-fold-pr.pdf

Its only about 50% effective, makes TB skin tests suspect, and TB hasn't been an issue in this country for a long time. Its also (up until recently) been comparatively easy to treat.

I did get it and activated yellow fever (also not routine) when I traveled to a third world country though.

[coalition_unwilling]

37. Um, I'm not a doctor or a biologist, but TB is a bacterial infection, not a viral infection. I don't

think you can innoculate against bacteria, only treat post-infection with anti-biotics.

This is why children are routinely screened for it with skin tests. In my case, I somehow was exposed to it as a child and picked up the anti-bodies, so will always test positive on skin tests. I have to get an X-ray instead of the skin test because of that.

If I'm wrong about this, I'll be more than willing to self-delete this post, since I'm the first to criticize scientific illiteracy.

[dipsydoodle]

39. Its a bacterial infection

usually treated with antibiotics. One of the problems with TB is that it can go almost unnoticed other than a cough for years.

There is a vac's but its effectiveness is erratic : http://en.wikipedia.org/wiki/Bacille_Calmette-Gu%C3%A9rin

[coalition_unwilling]

50. See my reply #49. I'm a total dumbass :) - n/t

[dipsydoodle]

52. No you're not

I had to search for what I posted. All I could remember was having a jab in 1953. It's curious that the innoculation don't work for everyone.

[FloridaJudy]

46. Diphtheria is bacterial

Last edited Mon Jul 9, 2012, 06:08 PM - Edit history (1)

And it's the "D" part of the DPT vaccine. There's also a vaccine for plague, but since only about 6 cases a year occur in the US (usually caught from wild rodents), it's not widely used.

Edited to add: oops! I forgot that there's also a vaccine for bacterial meningitis, and that one comes highly recommended. It's a devastating disease that can cause paralysis, brain damage and death.

[coalition_unwilling]

49. I had no idea, seriously. I think maybe I should self-delete my obviously ignorant post, but I don't

want to wipe out everybody's learned responses to it.

I'll leave my post to stand but believe I fundamentally erred when I wrote that you could not vaccinate against bacterial infections. (Also had no idea there was a vaccine for plague, so thanks for that

Yipes, I feel like a total dumbass. Turns out there's been a TB vaccine since 1921, per my friend at Google:

http://www.who.int/vaccine_research/diseases/tb/vaccine_development/bcg/en/

[FloridaJudy]

45. Nope

There is a vaccine - BCG - but it's not 100% effective. The problem is that anyone who ever got the vaccine will always test positive when the common skin test is done. That makes testing contacts to TB problematical: is this person testing positive due to tuberculosis, or because he or she had the vaccine? Since the vaccine doesn't offer reliable immunity, it could very well be both.

It is used pretty widely in other countries, but not here in the US.

[kooljerk666]

23. Tourism need this brought to their attention...........

Thanks to actions to steal money & ignore public health Florida is a a plague state.

Anyone would be dumb as shiit to go there on vacation & health boards across america should be bringing this to peoples attention.

I would avoid all adjoining states & states that treat the publics health so recklessly.

Cya later FL bureau of tourism & chamber of commerce.

I am gonna call Guv Corebitt (dimwit,1/2wit/nitwit/effin tool) whatever & public health depts & demand people be warned, I don't want anyone who handles anything I touch or eat or who I even talk to going there.

[Javaman]

27. Florida. nt

[bemildred]

29. Only the little people get sick. nt

[dembotoz]

30. you DO NOT MESS with tb

it is way nasty.
i met it up close and personal some years ago when my wife developed it during chemo.
Death cert says cancer
it could or should have said tb because it really fucked her up

[Quantess]

31. Shameful.

[Jackpine Radical]

33. I went to Matt Hudson's website & left the following comment:

How absolutely brilliant of Matt to cut off funding early for public health & the Holley State Hospital in advance of the current Jacksonville tuberculosis outbreak.

It is totally refreshing to see a politician with the courage to keep advocating for cutting funds for wasteful public services in the face of whiners like the Centers for Disease Control, who seem to think that controlling a tuberculosis epidemic should outweigh the need for reducing taxes on the most deserving of Americans, the rich.

[Blue Owl]

34. It's more important that welfare recipients take a precious piss test

[Blue_Tires]

38. God, if Scott was a dem we'd never hear the end of this...

[jtuck004]

41. Guy had TB, was sleeping on the food in back

We ran a call (ambulance) a few years back on a little cafe where a lot of city regulars, police, fire, business owners, etc ate.

Guy was coughing up blood, turned out to have active TB. He was sleeping on the potato sacks in the back, prepping food during the day.

All those who thought taking taxes and medical services from those with low income don't affect them got a lesson that day. A couple of the cops who ran the call (came out as a trouble unknown) turned a couple shades whiter than they were when they arrived, got in their cars and left. We saw them at the hospital later, apparently asking about TB tests.

This wasn't an isolated incident. For many immigrants housing\transportation is shaky and business owners will let them stay so they can be there, and small places that serve food are popular places for them to work. So just because you don't go to jails, homeless shelters, or mental health clinics...

The info in the OP about Florida isn't surprising. The US attorney there is working on a dozen or so slavery cases at any given time, historically many in the tomato fields. (You thought the 13th amendment banned that sort of thing, eh?).

Maybe that story will motivate some change.

[davidthegnome]

42. Hell with Scott, can't we go over his head?

Aren't there federal regulations in place to handle this? To prevent the outbreak from reaching a crisis like scenario?

I'm in Northern Maine, but in my neck of the woods, lots of folks from Florida vacation here, or have camps up here that they live in during the summer. Any one of them could unknowingly expose many others to the illness. Keeping it "quiet" apparently isn't working out too well and should not have been attempted in the first place. Yes, some of the citizenry may panic if we feel that a TB plague is inevitable, but forewarned is forearmed.

If the situation continues to worsen... well, I didn't live in the 40s or the 50s, but I have spoken with people who have. I've watched the documentaries - hospitals running out of room for the bodies and being forced to push them into rivers. Mass graves - the sort of nightmare scenarios we might see on television, but always expect we will never experience.

I'm a student of history, I know how scary this is. Unfortunately, many people born in the last few decades won't have any clue, or won't take it seriously. The whole damn world should be a little nervous about this. Considering how frequent and far reaching modern transportation is, considering that millions of us do not have access to preventative care or even (at the moment) any sort of health care aside from an ER visit. They could diagnose TB, but precious few are trained or have the knowledge to treat the current version or numerous versions of the disease that might develop.

This is scary.

[jpak]

43. Scott should be impeached - this is a "high crime" against the public.

yup

[FloridaJudy]

47. As a retired Public Health nurse

This not only infuriates me, it scares the living snot out of me.

[Yavin4]

48. Don't Tax Cuts Cure TB?

We'll soon find out, won't we.

[maddezmom]

54. Commentary: State risks public health by closing tuberculosis hospital

By Marc J. Yacht, M.D.

Former president of the Florida Association of County Health Officials.


By Marc J. Yacht, M.D.

As The Post’s Stacey Singer reported Sunday, Florida health officials were warned last April of a serious tuberculosis outbreak in Jacksonville shortly after Gov. Scott signed the bill requiring closure of A.G. Holley Hospital in Lantana. These efforts, spearheaded by Rep. Matt Hudson, R-Naples, included the dismantling and redefining of other Florida Health Department services. This continuation of a decade-long attack on health department authority included the forced exit and silencing of talented professionals committed to community health.

With knowledge of an outbreak that has been responsible for 13 deaths and 99 illnesses, Florida officials buried the report. A.G. Holley, the state’s only tuberculosis hospital, closed July 1 rather than six months later. Health Department action to thwart this outbreak has been questionable and ineffective at best. This outbreak among the Jacksonville homeless may have exposed several thousand residents, homeless and otherwise. Yet press releases paint a “happy face” on a potential statewide outbreak.

Florida ranked sixth in TB cases in 2010, and now has lost its major treatment facility for problematic TB cases. True, only a fraction of TB cases were housed at A.G. Holley. However, they tended to be indigent, uncooperative, often homeless, and a serious threat to spread the disease. Many of the Jacksonville cases may have been directed to A.G. Holley by a responsible administration with appropriate leadership in the Department of Health.

Only nine of A.G. Holley’s 36 patients have been accommodated at Jackson Memorial Hospital in Miami, according to a spokesman. The press release from the governor’s office claimed that 16 would be received by the facility. The other 27 patients may be deemed able to return to their communities — if they have one — and be followed by the health department. Now, folks exposed in Jacksonville need to be captured and tested immediately. Cooperation from hospitals that would receive these patients is more a hope than a reality.

more:
http://www.palmbeachpost.com/news/news/commentary-state-risks-public-health-by-closing-tu/nPppt/