The Will County Health Department said last week that active tuberculosis is on the rise in the county.
Sunny Hill Tuberculosis Clinic in Joliet reported eight cases of active TB since July 1, compared with only one case in the first six months of 2015. Each new active TB case requires constant monitoring and a specific regimen of antibiotics lasting six months or longer.
Dan Garganera, medical director of Sunny Hill, said he suspects that the number of local cases could continue to rise.
“Tracking TB cases and tracing their contacts is a huge undertaking requiring lots of manpower,” said Garganera, who is an infectious disease and internal medicine specialist with Southwest Infectious Disease Specialists Ltd. “More cases of active TB means a greater risk for Will County overall. TB is treatable, but treatment and prevention require lots of resources.”
Tuberculosis is an airborne bacterial infection spread by coughing and sneezing. The risk of TB infection is highest for persons with weakened immunity resulting from afflictions such as HIV/AIDS, diabetes, kidney disease, organ transplantation, cancer patients undergoing chemotherapy and individuals receiving specialized treatment for autoimmune disorders.
The health department said babies and young children are also especially susceptible because their immune systems may not be fully developed
“Antibiotic-resistant TB is obviously a special concern,” Garganera said. “Multi drug-resistant TB means the bacteria is resistant to at least 2 of the 4 first-line medications used to treat the disease. We are now also dealing with extensively drug-resistant TB, which means the bacteria has developed resistance to at least two of the backbone drugs used for TB treatment, and also resistant to one or more of the drugs constituting the second line of treatment.
Drug resistance will be a huge problem going forward,” he added. “We need new medications to fight a wide range of infectious diseases.”
Nearly 100 of the 9,412 TB cases reported in 2014 in the U.S. were drug resistant, and more than 66 percent of the 2014 cases occurred among foreign-born Americans.
“International air travel is a large and growing problem in terms of tuberculosis management,” Garganera said. “Active TB cases from other parts of the world [where TB is most active], create tremendous problems when they come to our shores and assimilate into the community undetected. One active TB case can easily infect many over a year’s time. And, the problem is significantly multiplied if the initial case happens to be an infection which is drug-resistant.”
To date, none of the active TB case in Will County have shown drug resistance, but Sunny Hill is monitoring two contacts of an extensively drug-resistant case, which entered the country via Chicago O’Hare in early April from India. At least 28 persons from various U.S. locations came in close contact with the traveler, who visited Missouri and Tennessee after departing Chicago.
Garganera said TB killed 1.5 million people worldwide in 2014.
“Drug-resistant TB is more common worldwide than it is here in the U.S., but international air travel means that someone with an active case of drug resistance thousands of miles away from us can hop on a plane and get here in a few hours,” he explained. “Imported TB from Asia, Africa and Central or South America is a serious threat.”
Sunny Hill, which also provides specialized TB services for Grundy County, devotes significant resource for area residents with latent TB. Persons with latent TB have been exposed to tuberculosis, but do not have active TB. More than 15 million Americans are thought to have latent TB and approximately 10 percent of them will eventually develop an active TB infection.
Persons with latent TB do not feel sick and cannot transmit TB to others. Nevertheless, they must be monitored and treated to make sure the bacteria in their bodies do not develop into active TB infection.
The Sunny Hill Clinic provides free TB skin tests to Will County residents twice weekly. For more information about services provided by the Sunny Hill Tuberculosis Clinic of Will County, call 815-740-4420.