Tamping Down the TB Panic

“This is not a major public health concern,” said Kris Ehresmann, director of infectious disease with the Minnesota Department of Public Health.

The potentially lethal lung disease has been on the decline for more than two decades.

She was talking about the incidence of tuberculosis in her state (or any state, for that matter) after a recent and somewhat alarmist report noted a slight uptick in TB incidence from 2014 to 2015 — and specifically in Minnesota, among its refugee population.

“It’s an important disease globally. A third of the world is infected with it. We certainly have to take it seriously and pay attention and invest in it, and public health across the country is doing that. But we’re seeing only about 150 cases a year here,” Ehresmann said.

“To focus the fear on any one group is not helpful — for so many reasons, but especially because people like me who are blond-haired, blue-eyed, and very pale have had TB. And you wouldn’t have stereotyped me in that role. I traveled to India when I was in college for a service study semester, and I returned home with an active case of TB. I’m in my own case files here at the health department.”

Tuberculosis is a disease we rarely hear about these days in the United States.

There were millions of cases of the potentially lethal lung disease globally and more than 25,000 cases reported annually in the U.S. back in 1993 — that was the year the World Health Organization declared tuberculosis a global emergency. Money, research, and efforts have been poured into eradicating the disease and preventing the spread ever since.

The potentially lethal lung disease, passed through the air from one infected person to another, has been on the decline in our country for over two decades. While the numbers have leveled off in recent years, the rate of infection in the U.S. is still considered low, even with a slight increase in cases from 2014 to 2015. The numbers rose from 9,406 to 9,563 respectively, with the highest numbers in California, Texas, and Florida.

[lz_bulleted_list title=”The Ongoing Toll of Tuberculosis” source=”http://www.cdc.gov”]There were 555 deaths from TB in 2013.|This is an 8% increase from the 510 TB deaths in 2012.|Overall, the number of TB deaths reported annually has decreased by 67% since 1992.[/lz_bulleted_list]

There are strong control measures in place in the U.S., said Ehresmann, and she doesn’t expect that to change. For those who do contract it, there are good treatments available.

Globally, however, it’s a different story.

As Ehresmann noted, one-third of the world’s population is infected with TB. In 2014, 9.6 million people around the world became sick with the disease and it caused 1.5 million deaths worldwide. Tuberculosis also remains a leading killer of people who are infected with HIV.

Complicating things further, there is a strain of TB that is increasingly resistant to the drugs currently available to treat it. Travel continues to put the greatest number of Americans at risk.

“Drug resistance in infectious diseases continues to be a huge public health problem, and it is not going away any time soon. Even drugs that currently work as antibiotics, history shows, will one day be ineffective due to resistance. Tuberculosis is one of those diseases where we have some tools, but these are becoming ineffective,” Dr. Cynthia Dowd, a chemistry professor at the George Washington University, told LifeZette.

Dowd is studying a promising possible treatment for malaria and tuberculosis with a five-year, $2.6 million grant from the National Institutes of Health. She is leading a team of researchers at five institutions.

“Drug resistance in infectious diseases continues to be a huge public health problem, and it is not going away any time soon.”

The research focuses on identifying enzyme inhibitors — molecules that stop a specific biochemical reaction — to fight the pathogens that cause malaria and tuberculosis. The enzyme, 1-deoxy-D-xylulose-5-phosphate reductoisomerase (DXR), is responsible for a chemical reaction necessary for malaria parasites and tuberculosis bacteria to survive.

While scientists and researchers work on better ways to fight active tuberculosis throughout the world, those who travel, who spend a lot of time with someone who does, or who have come from an area where TB is prevalent, should take precautions, Ehresmann said.

Otherwise, TB is not something most of us need to worry about. There are far more contagious and concerning diseases right now that should be on the radar screen, noted Ehresmann.

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“If I had measles and I walked past you, you could come down with measles. That is not the case with TB. The world is getting smaller and the role that global diseases play in a domestic environment, like Zika, are of bigger concern. For instance, in Minnesota, we don’t have mosquitoes yet [at this time of year] — and yet we have 14 cases of Zika. And those are all individuals who traveled internationally where Zika is occurring. More and more, global diseases are something we have to look at on the local, state, and federal levels.”