Boone County receives money for tuberculosis prevention and control

Saturday, August 20, 2011 | 12:00 p.m. CDT; updated 5:02 p.m. CDT, Saturday, August 20, 2011

COLUMBIA — A high number of tuberculosis disease and latent infection cases in Boone County has prompted the Centers for Disease Control and Prevention to award $11,730 to the local tuberculosis prevention and control programs.

“This is a great boon because we get to send our people to one of the four tuberculosis training centers,” said Mary Martin, public health manager at Columbia/Boone County Public Health and Human Services Department.            

Ten Counties/Cities with Highest LBTI Numbers

County                              Reported LBTI for 2010                    Total Population

St. Louis City                                   548                                                 354,361

St. Louis County                              398                                                993,512

Springfield/Greene County           269                                                263,793

Boone County                                   251                                                 152,049           

Kansas City                                       225                                                 450,375

Jackson (exc. Kansas City)              119                                                 352,064

St. Charles                                           74                                                 343,207

Clay (Exc. Kansas City)                    70                                                  114,735

Cape Girardeau                                   43                                                72,642

Jefferson                                               43                                                215,764                       

*All data supplied by Missouri Department of Health and Senior Services website.

This is the first time Boone County will receive state support for its tuberculosis program. The state health department distributes the money from the CDC.

Martin said most of the award will be used to send staff nurses and a physician who specialize in the treatment and prevention of tuberculosis to two of the four U.S. regional tuberculosis training centers. Two nurses will travel to the Southeastern National Tuberculosis Center in Florida, and another nurse and a physician will attend the more intensive program at Heartland National Tuberculosis Center in Texas. 

According to a city ordinance authorizing the grant agreement, $600 will be allocated for registration and tuition, $4,800 for travel, $4,792 for medical services and $600 for computer electronic items. Martin expects the Columbia City Council to approve the ordinance Sept. 6.

Martin said the rest of the money will be used to recoup costs the agency had previously been paying on its own, including translation services and labs.

Although largely eradicated in the United States through the availability of vaccinations and screening practices, tuberculosis remains the most deadly global microbial disease, infecting a third of the world’s population and killing 2 million to 3 million people per year, according to the Missouri Department of Health and World Health Organization websites.     

The bacteria, Mycobacterium tuberculosis, is spread via saliva droplets from the throat or lungs in the air when someone with the active disease coughs or sneezes.  Most commonly, it affects the lungs as pulmonary tuberculosis, but the disease occasionally can also spread and attack other areas of the body such as the kidneys and spine, Martin said. 

Classic signs of the active disease include night sweats, fever, weight loss, a chronic ragged cough and bloody sputum.

Not everyone infected will develop the disease, however. In most cases where a person comes in contact with the germ, the result is latent tuberculosis infection (LTBI), occurring when the body’s immune system contains the bacteria and renders it inactive.

The infection can lie in a state of dormancy for years and never become active.

Peter Lyskowski, deputy director of the Missouri Department of Health and Senior Services said in an email that, though people carrying LTBI are not infectious and cannot spread the disease, they can develop it later in life if not treated. Babies, the elderly or people with weakened immune systems are at a higher risk of developing the active disease from an earlier infection.

“Treatment of LTBI is essential to controlling and eliminating TB in the United States,” Lyskowski said.

Boone County had the fifth highest number of latent tuberculosis infections in the state in 2007 through 2009. It reported 285 cases in 2007, 217 in 2008 and 252 in 2009, according to the state health department. In 2010, the county ranked fourth highest, with 251 reported cases. Lyskowski said Boone County has recorded 110 LTBI cases and one tuberculosis disease case so far this year.

The data caught the state’s attention and served as the basis for the decision to provide the one-time award. Martin speculates the high number of infections is due to the three universities in Columbia and the transient and diverse nature of that community.

“This is a global community,” Martin said.

Tuberculosis control is nothing new for the Health Department because all counties are required to have a tuberculosis prevention and control program. Martin said the nurses and physician who will be sent to the training centers are already very knowledgeable in tuberculosis prevention and treatment, conducting directly observed therapy, managing tuberculosis treatment regimen education for all patients and following up on labs and medications.

Through the training opportunities Martin is “hoping they will have an increased knowledge base.” 

“They do everything now,” Martin said, “but to be more educated in something is better.”

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