CA Leads US in Drug-Resistant TB Cases Typical of Immigrants
California Leads U.S. in TB Infection—Drug-Resistant Cases Prevalent Among Immigrants
As TB Rates Go Down, Drug Resistance Causes Worry
Monday, March 23, 2009
By Juliana Barbassa, Associated Press
San Francisco - Even as tuberculosis rates decline in the United States, drug-resistant strains of the disease showing up in states with large immigrant populations and are becoming increasingly hard to treat.
Researchers are concerned about this trend while funding for labor-intensive disease control programs is being cut in cities such as San Francisco, which has the highest TB rates in the country.
Drug resistance develops when patients start feeling better and interrupt their treatment, giving bacteria an opportunity to develop a defense against the medication.
The picture is grim, and World TB Day on Tuesday is an attempt to raise awareness of a disease that infects about 9 million people, particularly in Asia and Africa. About five percent of those patients are immune to the best drugs. About 2 million die annually.
Immigrant communities in states such as California are particularly vulnerable because many people are foreign born or travel frequently to countries where TB is a greater risk, such as Mexico, India and China.
California leads the nation with 2,696 TB recorded cases in 2008 and with 451 cases of drug-resistant TB identified between 1993 and 2007. About 83 percent of these drug-resistant cases involve immigrants born abroad.
"California, having so much exposure to the world via immigration and travel, is particularly at risk," said Gil Chavez, deputy director of the California Department of Public Health.
Patients with multidrug-resistant tuberculosis do not respond to the most commonly used antibiotics. Of even greater concern is extensively drug resistant tuberculosis, which is even more resistant to an even greater number of drugs, making treatment extremely difficult.
A statewide analysis of drug-resistant TB cases between 1993 and 2006 found the proportion of patients that were one drug away from becoming extensively drug resistant grew from 7 percent to 33 percent.
“It’s a wake-up call,â€
