Missouri: Health Officials Warn of Possible Link Between Shelter Use, TB

On Monday, government health officials issued an advisory urging St. Louis-area medical workers to test the homeless for tuberculosis, warning that shelters are the likeliest sites for the disease to be spread. Since 2001, there have been 15 active TB cases among residents of the city's dozen or so public and private shelters, and officials expect the onset of cold weather could soon double or triple shelters' use.

Last year, Missouri reported 136 TB cases, the lowest number since it started recording them in 1944. There were 157 cases in 2001 and 211 in 2000. TB among St. Louis' homeless prompted the advisory, which does not apply to other Missouri cities.

"We are targeting the St. Louis area because of this outbreak," said CDC's Lynelle Phillips. City health officials, aided by CDC, hope to bolster screening and tracking of shelter users. Crews are installing TB-killing ultraviolet lighting and more powerful air filters in the city's largest shelter, the Salvation Army's Harbor Light Center. Recent chest X-rays showed that none of roughly 230 Harbor Light clients was carrying TB, said Ted Misselbeck, a CDC public health advisor in St. Louis. Missouri offers a course of antibiotic treatment free to anyone diagnosed with TB.

Last year, there were 15,078 TB cases in the United States, down from 2001 by about 6 percent according to CDC.

Elsewhere in the nation, at least six homeless men have been diagnosed with TB in Portland, Maine, since August 2002, in the city's first outbreak since 1989. In the past year, a TB outbreak among the homeless in downtown Seattle boosted the number of King County cases to a 30-year high.

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