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World TB Day


Santa Clara County, CA. While Tuberculosis (TB) rates have decreased over the last year in Santa Clara County, the rates remain too high. The TB rate in California is 5.8 cases per 100,000 people, declining slightly from 6 cases per 100,000 people, while the TB case rate in Santa Clara County was 10 cases per 100,000 in 2011. This is down from 10.7 per 100,000 in 2010. The San Jose-Sunnyvale-Santa Clara metropolitan area continues to have one of the highest case rates of any metropolitan area in the United States.
In 2011, Santa Clara County had the fourth highest number of TB cases and the third highest case rate when compared to other California counties. Santa Clara County had 181 TB cases in 2011, down from 193 in 2010, which is the largest decrease in recent years.  If left untreated, TB can be a fatal disease.  From 2009-2010, twenty-six Santa Clara County residents with TB died, which was about seven per cent of all TB cases.  Most of the TB deaths were elderly residents, and those who had serious medical conditions.
TB is a bacterial lung disease that can remain dormant in infected individuals for years. Those who are infected with TB often don’t know it because their infection is “latent” or inactive and doesn’t make them or others sick. Once the infection becomes active, the infected individual is contagious. People with latent TB need to be treated to prevent the progression to active TB. Inappropriate or incomplete drug therapy by those with active TB can lead to multi-drug resistant (MDR) TB.
“The partnership between our TB program and key partners, such as the Santa Clara County TB clinic and other community providers, has been essential for reducing our TB case numbers and getting people through treatment,” said Dr. Marty Fenstersheib, Health Officer for Santa Clara County.  “Working together, they ensure that all cases of TB are treated properly and that people who are exposed to infectious cases of TB are evaluated and treated.” 
Many TB patients receive their medication by directly observed therapy (DOT), which means that a public health worker visits them daily to monitor their symptoms and watch them take their anti-tuberculosis medications.  The county’s TB program recently began administering DOT by videophone to a limited number of TB patients.  “Videophone DOT allows more flexibility for administering DOT while saving on travel costs and is a win-win for both the patient and the Public Health Department,” said Dr. Fenstersheib.  “It enables us to use technology to improve both service and outcomes for our patients.”
This year’s World TB Day event was held at the Santa Clara County Public Health Department on March 22, 2012. Dr. Gulshan Bhatia, the former Medical Director of the Santa Clara County TB clinic, was recognized for her years of service.  Under Dr. Bhatia’s leadership, the TB clinic has become a nationally recognized center for the treatment of TB and cares for about half of the county’s TB patients.  Dr. Jennifer Flood, the TB controller for the state of California, also provided an update on current data of TB deaths throughout California.
“Now is the time to keep funding programs that fight TB,” said Margo Sidener, President and CEO of Breathe California of the Bay Area. “We have made good progress in recent years, and if we lose our public health infrastructure because of budget cuts, we will pay more in future healthcare costs.”
TB is a global health issue, with one third of the world’s population infected, according to the Centers for Disease Control and Prevention. Each year, there are nearly 2 million TB deaths worldwide. The Bay Area, including Santa Clara County, is home to many people who frequently travel to and from areas around the world with high TB rates, increasing the risk for TB exposure and infection in our community. The TB Prevention and Control Program estimates that as many as one in ten Santa Clara County residents may be infected with TB.
The Santa Clara County Public Health Department works with local health care providers to stop the transmission of TB by identifying TB cases and following them through the completion of therapy. In addition, when an active case is identified, those who have come in close contact with the person must be evaluated and screened for TB. The Public Health Department conducts about 1,250 of these contact investigations each year. About one-third of those who have been in close contact with someone who has active TB become infected with latent TB (the non-contagious form) and one percent of those contacts are diagnosed with active TB.
The Tuberculosis Prevention Partnership is co-chaired by Breathe California of the Bay Area, Asian Americans for Community Involvement, and the Santa Clara County Public Health Department. Since 1999, the coalition has focused on prevention, education and advocacy in a community-wide effort to reduce the impact of TB.

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