March 13, 2002
The number of reported tuberculosis cases has dropped to a record low in Missouri, but officials warn that the disease has yet to be eradicated. Missouri has 157 cases of TB in 2001, representing the lowest level since the state began keeping records in 1944. It also represents a 26 percent decrease from the 211 cases in 2000. While the fight isn't over, the state's goal of eliminating TB by 2010 may not be realized. "We cannot quit hammering it," said Ron Williams, director of the Missouri Rehabilitation Center in Mount Vernon, where the state operates a TB lab and treatment unit.
For those who are trying to control the disease, the problem is the reintroduction of the TB bacillus into areas that have been free of the disease or at least free of potential exposure. A significant number of Missouri's TB cases can be linked to refugees or immigrants from other countries, Williams said. The Bosnian refugees who live in the St. Louis area are an example. Several TB cases have been identified in that group. "Refugees and immigrants who come from countries that do not screen for the disease will continue to be a source," he said.
Homeless individuals pose a special problem. Treatment cannot always be structured in a way that is successful for homeless persons who become ill with the disease. In such cases, homeless individuals are placed by court order into the TB unit in Mount Vernon for directly observed therapy.
Vic Tomlinson, chief of the TB program for the Missouri Department of Health and Senior Services, said he is encouraged by the numbers. "It's because a lot of people are working very hard -- nurses, outreach workers, local health departments, private physicians and homeless shelters -- to get the job done."