The number of tuberculosis cases in the state decreased overall last year, but three counties in the central San Joaquin Valley and 16 others statewide reported more people with the infectious disease.
Madera County, which had 21 cases, ranked second statewide for cases per 100,000 population, according to 2008 state statistics. In 2007, the county had only one person with tuberculosis. San Francisco ranked first in 2008, with 118 cases.
California saw a drop in TB cases from 2,725 in 2007 to 2,696 in 2008, but the state remains an epicenter for the disease. The tuberculosis rate in the state is 60% higher than the rest of the nation. The American Lung Association in California said every Californian's health is at risk from a lack of money for prevention and control of tuberculosis.
A recent federal study found "120 positions in TB control statewide have been lost due to budget cuts in the last three years," said Trisha Murakawa, the association's board chair, at a teleconference Monday in recognition of World TB Day, which is today.
According to the California Department of Public Health, Fresno County reported 73 cases in 2008, compared to 42 in 2007. It ranked 13th among counties for TB cases per 100,000 people. Tulare County had 33 cases in 2008, compared to 25 in 2007. It ranked 17th.
Tuberculosis is caused by bacteria that are spread through the air when a person coughs, sneezes or talks.
Local and state health officials said the increases in TB cases in Valley counties last year could be one-time occurrences.
Madera County traces the increase to two cases at Madera High School South. Those two cases led to a number of other people who were exposed to tuberculosis and became contagious, said Carol Barney, the county's health director.
In Fresno County, a number of people had tuberculosis for long periods and spread the disease to others before they were identified in 2008, said Dr. Kenneth Bird, the deputy health officer and tuberculosis controller.
County health officials said it takes money to prevent and control tuberculosis. What funds they receive from the state are not enough, Barney said.
Madera County received $9,000 for prevention and control from California last fiscal year, she said. "It doesn't even cover two months of medications," she said. The county spends $25,000 to $30,000 annually on medications to treat TB patients, Barney said.
Counties also use money from vehicle license fees to pay for TB control and other health services -- and those funds have been declining.
Fresno County reduced nurse visits to tuberculosis patients because of budget cuts. Nurses no longer visit every patient twice a day to ensure medications are taken. Only those at risk of skipping doses get the visits. Tuberculosis germs can become resistant to the drugs that kill them if doses are missed.
Dr. Gil Chavez, deputy director in the California Department of Public Health and chief for the center of infectious diseases, said every department in California took a 10% cut last year, including tuberculosis prevention and control. But the recent round of budget reductions for the current year and next year do not include cuts to the TB program, he said.The reporter can be reached at firstname.lastname@example.org or (559) 441-6310.