Important note: Information in this article was accurate in 2004. The state of the art may have changed since the publication date.
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San Francisco Examiner - March 25, 2004
Alison Soltau, Staff Writer
With a cosmopolitan mix of new migrants and a large homeless population, The City's TB infection rate is four times the national average, said Dr. Masae Kawamura, director of the San Francisco TB Control Program. The specter of SARS, anthrax and other bio-terrorist threats loom so largely in the media that the public forgets that tuberculosis left untreated is a far greater killer, she added.
She said it was na ve to assume that the disease was confined to the homeless and poor, pointing out that the financial heavyweight Charles Schwab on Fremont Street recently had an employee diagnosed with the disease, prompting a Department of Public Health investigation.
No other employee was found to have developed the disease.
"It's been in the courthouse, it's been in the Pacific Exchange, high school teachers, preschool babies," she said. "It can really hurt anyone and we could turn back the clock to the time [in the 19th century] when it was in every household."
Officials at the TB Control Program were dismayed to learn recently that the funding from the Center for Disease Control and Prevention will be slashed by $500,000 in the upcoming budget.
"We will do everything to be creative to not cut our services but I think it's inevitable that we will make cuts to our community screening network," Kawamura said."We will just be putting band aids on and using the money to treat, rather than prevent.And that's a real shame when we were just making real progress."
While incidents of the disease have declined steadily over the past decade, The City reported 162 new cases in 2003, an 11 percent increase from 2002, the DPH said.
In 2003, the highest rate of the disease occurred among the Asian/Pacific Islander population, accounting for 108
cases. The reason for that is because of the influx of migrants from China and other southeast Asian countries which have less controls on the disease, said Dr. Alexander Li, medical director at the Chinatown Public Health Clinic.The U.S. does not generally screen people on working and tourist visas for TB. As a result, scores of low-income migrants flock to the center for screening and care.
"Poor people tend to live closer together, increasing the chance of infection," Li said.
TB facts
What is tuberculosis?
Tuberculosis, or TB, is a bacterial disease that usually affects the lungs, but can affect other parts of the body.
How is TB spread?
TB is spread when the infected and untreated person coughs or sneezes. Prolonged exposure is necessary for the infection to be transmitted and it is not transmitted through sharing food or having sex.
Who gets TB?
TB can affect anyone. People with increased exposure include the foreign born, homeless, incarcerated and those with a weakened immune system from HIV or cancer.
What are TB's symptoms?
Symptoms include a persistent cough, weight loss, low-grade fever, night sweats and fatigue. TB can also remain latent, in which case it is not infectious. Some 50 percent of people with active TB will die if they leave it untreated.
Information provided by San Francisco Department of Public Health.
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