On World Tuberculosis Day, March 24, 2005, the New Jersey Department of Health and Senior Services (DHSS) announced that its efforts to eliminate tuberculosis (TB) transmission resulted in a 51 percent decline in total cases in New Jersey from 1992 to 2004. More than two-thirds of all New Jersey cases now involve people who contracted TB in another country. TB is caused by a bacterium, and is typically spread by coughing or sneezing. It is highly treatable and almost always curable with appropriate treatment.
"New Jersey is a major immigration destination and transportation hub," said DHSS Commissioner Fred M. Jacobs, MD, JD. "On World Tuberculosis Day it is important to note how TB infections in the rest of the world impact us here in the Garden State."
Immigrants are not granted entry visas for the United States if they have infectious TB, but immigrants with non-infectious TB can receive visas. In these cases, the Centers for Disease Control and Prevention (CDC) in Atlanta notifies New Jersey's public health community. Each person entering the country with TB is then contacted and provided with treatment options.
In 1986, 78.3 percent of New Jersey's TB cases involved people who were born in the United States. In 2004, more than 70 percent of all cases in New Jersey involved foreign-born residents. There has been a nearly 25 percent increase in incidence among Asian-Pacific Islanders in New Jersey between 1992 and 2004. Latinos have seen the incidence of TB in their population fall slightly during the same time period with a 6.4 percent reduction.
In contrast, the greatest decline in TB cases in New Jersey is among African-Americans and whites. The majority of both these populations in New Jersey are born in the United States. From 1992 to 2004, cases among African Americans fell 76.3 percent and cases in whites fell 73.3 percent.
Healthcare disparities aren't only related to race or age, but they also relate to characteristics such as country of origin," said Thomas Privett, DHSS Tuberculosis Program manager. "Doctors treating foreign-born populations, especially those from the Asia-Pacific region, who see persistent cough or other symptoms consistent with TB should always consider TB as a diagnosis."
TB primarily affects the lungs, but can also affect other parts of the body such as the brain, kidneys or spine. Symptoms include a cough that lasts more than three weeks, chest pain, coughing up blood or sputum, fatigue, loss of appetite and weight, fever and night sweats. Individuals who have a combination of these symptoms should consult a physician, emergency department or local health department for evaluation.
TB patients are treated with several different drugs for at least six months to ensure all of the bacteria that caused the disease are killed. Those with active TB are only infectious when disease is located in the lungs and/or voice box, and even these individuals can be quickly rendered non-infectious with appropriate treatment. Persons with TB infection who do not show symptoms are generally not infectious.
New Jersey has local, state or federally funded TB clinics in all 21 counties. Nurses and specially trained outreach staff work directly with patients, providing individualized services at home, work or a clinic to ensure they complete the course of treatment and their contacts are tested for TB.
If patients with active TB disease do not stay on their medication for its full course, they run the risk of not only infecting others, but of developing a drug-resistant form of the disease. That is why State and local health departments and TB clinic staff meet with patients as often as five times a week, checking to make sure that medicine is being properly taken, and that it is having its desired effect. The outreach workers even provide transportation to and from clinics and hospitals as needed.
Source: New Jersey Department of Health