Monday marks the 126th anniversary since the discovery of the germ that causes tuberculosis, but the disease has not disappeared and remains a health problem in the San Joaquin Valley and worldwide, say infectious disease officials.
"TB is not eliminated. And in fact, worldwide it's the second leading cause of death by infectious disease," said Dr. Kenneth Bird, the deputy health officer and tuberculosis controller for Fresno County.
California counties are particularly impacted by tuberculosis. The TB rate in the state is 60% higher than the rest of the nation. California had 2,276 cases in 2007. Last year, Fresno County had 42 cases of TB. Valleywide there were 186 cases in the eight counties from San Joaquin County to Kern County.
About a third of the world's population is infected with tuberculosis, Bird said. "And with the ease of world travel now and world migration, it's a threat everywhere."
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Adding to the threat is the increasing number of multidrug and extensively drug resistant cases of TB that are identified each year, said Barbara Cole, a registered nurse from Riverside County who is a volunteer board member of the American Lung Association of California.
Each year in California, about 30 to 40 cases of multidrug-resistant tuberculosis are reported, Cole said.
And there have been 19 cases of extensively drug resistant TB since 1993.
Regular TB cases require treatment with antibiotics for a minimum of six months, Cole said.
Multidrug-resistant cases can take 18 to 24 months to treat and are harder to control because they're resistant to some antibiotics.
The extensively drug resistant cases are resistant to even more drugs and are the hardest to treat, she said.
Fresno County reported one multidrug-resistant case of TB last year.
TB is caused by bacteria that are spread through the air when a person coughs, sneezes or talks. People can be infected and not be ill.
They do not spread the disease to others. But this "latent" form of TB can progress and cause illness.
Symptoms of TB include a cough that lasts longer than two to three weeks, coughing up blood, weakness or fatigue, weight loss and loss of appetite.
People at highest risk of TB in the Valley are new immigrants who arrived in the past five years, Bird said. Other groups at risk are the homeless, people with drug addictions, jail inmates and people with weakened immune systems, he said.