Thursday, February 7, 2019

TB Is Making A Comeback In The U.S.



TB is on the rise



After more than two decades of steady decline in active cases of tuberculosis in America, the trend has now reversed.

CDC stats from 2017 show that 70% of reported cases of TB in the United States was found among non-U.S.-born individuals.  Migrants from Mexico accounted for the largest share.

On top of that, we're seeing strains of TB that are multi-drug resistant (MDR).  And as dangerous as these strains are, we're seeing even more lethal strains that are extensively drug resistant (XDR).

Meanwhile, as you might imagine, treating tuberculosis is labor-intensive and costly.  The treatment regimen lasts at least six months, if not longer.  Some programs require that health care workers witness patients swallowing every dose of medication and that they monitor them for side-effects.  If a patient can't get to a health clinic, the worker goes to wherever the patient resides.  All the while, cultural and language barriers present additional challenges.

Then there's the financial cost.
For patients who respond to standard treatment, the cost of treating active TB is about $17,000 per person.  For those who have drug-resistant strains, the cost is anywhere from $130,000 to $430,000, depending on how resistant the strain is.
Got that?  Taxpayers may shell out nearly half a million dollars to treat one case of a drug-resistant strain of TB.

Then there's the issue of tracking.  After folks develop active disease, tracking them is spotty.  So if they fall off the radar, oh, well.

California, Texas, New York, and Florida (states with the largest number of foreign-born residents) have more than half the active TB cases in the country.  Despite California having the largest TB prevention and control program, its infection rate is nearly twice the national average, though that figure is likely higher since about 2.5 million Californians who are infected are unaware they have it.

In addition, data from just a few years ago in Minnesota showed that 26% of all foreign-born cases of TB were Somalis who came here through the "refugee resettlement" program and 20% of these colonizers forced upon the good people of Minnesota tested positive for latent TB (latent TB is not contagious, but it can turn into active TB, which is contagious).

On and on it goes.  The same pattern is seen everywhere: an uptick in TB due in large part to an influx of people from impoverished countries (herehereherehereherehere, and here).

The impact of this is devastating. Border patrol is on the front line, battling diseases, as its people contend with sick migrants, most of whom aren't vaccinated.  Buildings have become infested with scabies.  Many of the illegal wannabes showing up with symptoms aren't being quarantined.  And our resources are being depleted and misdirected.




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