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Virginia: TB Preventable, Treatable -- and Rising

May 5, 2003

Despite a record low nationally last year, tuberculosis cases continue climbing in Fairfax County, Va., and officials are warning that more money and stronger initiatives are needed to contain the disease. Of the 315 cases reported across Virginia in 2002, the highest concentration -- 31 percent -- was in Fairfax. The latest CDC report put the county's TB rate at 9.8 percent per 100,000 residents. That is almost twice the national rate of 5.2 cases and represents more active cases than in all but 14 U.S. cities, officials said.

Fueling the trend is the surge in immigration, which officials said drives up the number of infections as people move to Fairfax from other countries -- primarily Mexico, the Philippines and Vietnam -- where the disease is common. Of the 177 cases identified in Northern Virginia last year, 87 percent were foreign born, originating from 38 countries and speaking 15 different languages.

While health experts and local officials stopped short of characterizing the problem as a crisis, they did say more should be done to quickly treat people infected with the disease by providing free medications. Virginia is one of two states that do not automatically provide TB drugs -- although state health officials said that in practice, no one is denied treatment. Drug costs are covered for the indigent, they said, and a sliding scale is used if private insurance does not cover the cost. The state will also step in if a patient cannot meet their deductible, officials said. Critics point out that the state pays for medications to treat STDs and anthrax, and they argue that paperwork hassles or costly deductibles can cause patients who need treatment to miss their chance to get it.

Fairfax health officials in February hired for the health department a TB consultant and nursing coordinator. The nursing coordinator manages eight nurses -- some bilingual -- who will focus their efforts on TB and long-term care issues. The goal, officials said, is to identify and target at-risk residents who may be reluctant to seek TB screening. Besides fearing the stigma attached to TB, one official said, "many don't want to get involved with any governmental agency because of the governments they've encountered in the countries they've come from."

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Excerpted from:
Washington Post
05.01.03; Leef Smith

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