March 24, 2004

Contact:
Andy Weisser, (818) 703-6444, aweisser@earthlink.net
www.californialung.org
or your local American Lung Association at (800) LUNG-USA.

California TB Cases Increase as Nationwide TB Cases Decrease
--More Cases Seen in 28 Local Areas

American Lung Association of California Cautions Against Relaxing Prevention Efforts on World TB Day, March 24

Editors Note: County-specific tuberculosis statistics are available through the American Lung Association of California's web site, www.californialung.org and/or by contacting the American Lung Association at the above numbers.

Related news conferences will be held as follows:

• San Francisco: Details being confirmed. Contact: Eileen Shields, 415.554.2507
• San Jose: 11 a.m., March 24, Santa Clara County Medical Association, 700 Empey Way

(EMBARGOED: Oakland, CA, March 24, 2004) - Although tuberculosis (TB) cases dropped 1.4 percent nationwide (the smallest decline in recent years), cases have increased 1.9 percent in California, with increases seen in 28 local areas, (up from 18 local areas, compared to the previous year). As public health advocates worldwide prepare to mark March 24 as World TB Day, the American Lung Association of California calls on the State of California to avert a resurgence of tuberculosis in this state by increasing funding for tuberculosis (TB) prevention and control efforts.

California continues to report the highest number of TB cases in the United States. Case increases were experienced last year in Butte, Colusa, Contra Costa, Del Norte, Fresno, Glenn, Lake, Long Beach, Madera, Marin, Monterey, Nevada, Orange, Pasadena, Placer, Riverside, Sacramento, San Bernardino, San Francisco, San Joaquin, San Luis Obispo, Santa Barbara, Santa Cruz, Shasta, Solano, Tehama, Ventura and Yolo.

In the previous year, Alameda, Imperial, Inyo, Kern, Long Beach, Madera, Mendocino, Merced, Napa, Riverside, San Joaquin, Santa Clara, Sonoma, Stanislaus, Sutter, Tulare, Ventura and Yuba experienced case increases.

The rate of TB in California remained steady at 8.9 cases per 100,000 residents. There were 3,230 cases of TB reported in the state in 2003, a 1.9 percent increase compared to 3,169 cases reported in 2002. California is far from the national 2010 objective of one TB case per 100,000. The case rate for children, ages zero to four, increased four percent. After a resurgence of TB in the late 1980s, the public health network was renewed and cases declined from the 5,382 reported at the height of the California epidemic in 1992 until 2001.

Wide disparities continue in the rates of TB among California's racial and ethnic groups: the rate for Asians/Pacific Islanders is 30.4 per 100,000 individuals; for African-Americans it is 10.4 per 100,000; the rate for Hispanics is 11.0 per 100,000; for American Indian/Alaskan Native it is 3.2 per 100,000; and for White, Non-Hispanic, 1.9 per 100,000.

"One hundred years after the American Lung Association was formed out of public health necessity to control TB, the battle is still not won," said Barbara Cole, RN, MSN, PHN, a volunteer board member of the American Lung Association of California and chair of its Tuberculosis Technical Advisory Group. "When government makes it a priority and funds the necessary control efforts, the TB rates decline," she added. "When the government does not make this investment in public health, we experience a resurgence."

Historical state and federal government budget cuts resulted when it was perceived that TB was no longer a threat. This lead to a TB disease resurgence throughout California in the late 1980's. Funding was increased and a steady decline of TB rates from 1993 to 2000 resulted. Now, however, state funding is in jeopardy again.

In FY 2001-2002, $400,000 was cut from the State TB Control Local Assistance Budget. These cuts have not been restored and these and other potential future cuts could inhibit the ability to evaluate exposed individuals in a timely manner, which could result in more people progressing to active TB.

While acknowledging that California is facing a serious budget shortfall, the American Lung Association of California believes that delaying the restoration of these important local TB funds may put the state at risk for enormous future health expenditures should a serious TB outbreak occur.

TB is transmitted through the air when an individual with active TB coughs or talks. Anyone inhaling air containing the TB bacteria may become infected. Patients with latent TB infection can be treated to prevent progression to active TB disease. It takes six months or more for appropriate medications to cure active TB disease.

Inappropriate or incomplete therapy can lead to TB patients developing and spreading strains of multidrug resistant TB, which means the germs are resistant to the best available drugs. Multidrug resistant TB can be untreatable and has been listed by the Federal Centers for Disease Control and Prevention as a possible agent of bioterrorism. Multidrug resistant TB cases increased 40 percent from 2001 to 2002.

TB is a preventable, treatable disease. However, TB has reached epidemic levels worldwide. An estimated one-third of the world's population (2 billion people) carry latent TB infection. Each year, approximately 8 million new cases occur and nearly 2 million people die from the disease globally. TB is the leading cause of death for people with AIDS and the leading cause of maternal mortality.

The American Lung Association has long funded vital research on the causes of and treatments for lung disease. It is the foremost defender of the Clean Air Act and laws that protect citizens from secondhand smoke. The Lung Association teaches children the dangers of tobacco use and helps teenage and adult smokers overcome addiction. It educates children and adults living with lung diseases, including asthma, emphysema and tuberculosis, on managing their condition. With the generous support of the public, the American Lung Association is "Improving life, one breath at a time." For more information about the American Lung Association or to support the work it does, call 1-800-LUNG-USA (1-800-586-4872) or visit www.californialung.org.