March 22 , 2007

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

Although Statewide and Nationwide TB Cases Decrease, TB Cases Increase in 20 Local California Areas

-- American Lung Association of California Urges Investment in Prevention Efforts on World Stop TB Day, March 24

(Embargoed: Oakland, CA, 9 a.m. Pacific, March 22, 2007) Although tuberculosis (TB) cases dropped 2.3 percent nationwide (2006 compared to 2005), and 4.2 percent in California, increases were experienced in 20 local California areas (33 percent of California’s 61 health jurisdictions). On World TB Day (March 24), the American Lung Association of California emphasizes that the declining number of cases continues to slow and calls on the State of California to avert a TB resurgence in this state by increasing funding for prevention and control efforts.

“TB anywhere is TB everywhere,” said Barbara Cole, RN, MSN, PHN, a volunteer board member with the American Lung Association of California and chair of its Tuberculosis Technical Advisory Group. “Although TB is almost completely curable, every four days, a child under five years of age contracts TB in California and 200 Californians die every year with TB.”

California continues to report the highest number of TB cases in the United States. Case increases were experienced last year in Colusa, El Dorado, Glenn, Imperial, Lake, Mendocino, Merced, Napa, Placer, Riverside, San Benito, San Diego, San Joaquin, San Mateo, Santa Clara, Sonoma, Stanislaus, Sutter, Trinity, and Tulare.

In the previous year, Alameda, Berkeley, El Dorado, Imperial, Kern, Kings, Lassen, Madera, Mendocino, Monterey, Nevada, Orange, Pasadena, Placer, San Luis Obispo, San Mateo, Santa Barbara, Santa Cruz, Shasta, Siskiyou, Sutter, Tehama and Yolo experienced case increases.

An estimated 1.4 million Californians are infected with the bacterium that causes tuberculosis. Most of those who are infected don’t know it, because their infection is “latent” or sleeping, and doesn’t make them or others sick. But if and when it wakes, TB can kill them if it is not treated. If the infected Californians are not located and treated, 7,000 of them may develop active TB in their lifetime. TB usually activates in the lungs, making the person sick and infectious.

The rate of TB in California decreased slightly to 7.4 cases per 100,000 residents in 2006 (from 7.9 in 2005). There were 2,781 cases of TB reported in the state in 2006, a 4.2 percent decrease compared to 2,903 cases reported in 2005. California is far from the national 2010 objective of one TB case per 100,000. 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.

“More than 100 years after the American Lung Association was formed out of public health necessity to control TB, the battle is still not won,” said Cole. “There is a direct cause and effect correlation: When government makes it a priority and funds the necessary control efforts, TB rates decline, and California becomes a healthier state” she added. “When the government does not make this investment in public health and prevention, we experience a resurgence. The American Lung Association of California, along with others, continues to advocate to maintain the crucial sources of TB prevention and control budgets.”

In the past, when TB was perceived as no longer a threat, local, state and federal funds were cut which led to 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.

In fiscal year 2001-2002, $400,000 was cut from the State TB Control Local Assistance Budget. These cuts have not been restored. In addition, federal funds to California were cut 12 percent since 2005, and more federal cuts are expected. These 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 in the lungs coughs or talks. It takes six months or more for appropriate medications to cure active TB disease. 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.

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. Each year in California, there are approximately 60-80 multidrug resistant TB patients undergoing treatment. Recently, extensively drug resistant TB (XDR TB) has emerged worldwide; these are strains that resist even more medicines and raise the specter of virtually untreatable TB. Fifteen cases of XDR TB have been detected in California since 1993.

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 8.8 million new cases occur and nearly 2 million people die from the disease globally. TB is a leading cause of death for people with AIDS.

For 100 years, the American Lung Association has been the lead organization working to prevent lung disease and promote lung health. Lung disease death rates continue to increase while other leading causes of death have declined. The American Lung Association funds vital research on the causes of and treatments for lung disease. 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 or www.lungusa.org.call 1-800-LUNG-USA (1-800-586-4872) or visit www.californialung.org.