Tuberculosis cases on decline in South Dakota

Tuberculosis cases on decline in South Dakota As World Tuberculosis Day, March 24, approaches, a state health official says cases in South Dakota are on the decline.

"We do see some fluctuation in TB numbers from year to year but our general trend is downward," said Kristin Rounds, tuberculosis control coordinator for the department of health. "We're also seeing fewer cases among children, a sign the TB control system is working."

According to the Centers for Disease Control and Prevention, South Dakota had the sixth greatest decrease in reported cases from 1992 to 2002. During those 10 years, South Dakota tuberculosis cases dropped from 32 to just 13, a decrease of 59.4 percent.

Rounds attributed the declining numbers to an aggressive state tuberculosis (TB) control program. The state's communicable disease law requires that all suspected cases of TB be reported to the department of health. The department screens those at risk for TB, conducts active surveillance to promptly identify cases, and ensures that those with the disease complete the lengthy course of medication.

TB control services are provided at no charge and include anti-TB medication, diagnostic laboratory services, nurse case management of all cases, contact investigations for persons exposed to TB cases, and educational materials and treatment guidelines for health-care providers.

"South Dakota's preventive therapy program has been very successful in keeping TB infections from breaking down into active disease," said Rounds. In 2002, the department started 566 individuals on preventive therapy. A total of 13 cases of active TB were reported in 2002, the same number as the year before.

Rounds emphasized that there is a difference between TB infection and active TB disease. TB infection results in a positive TB skin test but there are no symptoms of TB and no TB organisms found in the sputum. In contrast, active TB disease is characterized by symptoms and the presence of TB organisms in the sputum. Rounds said TB germs are spread only by those with active disease and that infection is not enough to spread the germ. TB may last for a lifetime as an infection and never develop into active disease.

"Even though TB cases are declining it's important that we continue to watch for this disease, especially in patients who have risk factors for TB," said Rounds. "If we become complacent about screening and prompt identification of TB, we will quickly lose the gains we've made in recent years."

Individuals at risk for TB include those with close contacts to active TB cases, with diabetes or on renal dialysis, with alcoholism, with suppressed immune systems, the foreign-born and the homeless.

TB is a bacterial disease usually affecting the lungs, although other parts of the body may also be affected.

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