Increase in Valley TB rates coming

McALLEN - Tuberculosis rates in Texas and the Rio Grande Valley have remained steady the last few years, but a spike in TB cases is coming, health officials warned Thursday.

"We've seen an increase in cases in Texas," said Charles Wallace, manager of Texas Department of State Health Services' Infectious Disease Intervention and Control Branch. "The kinds of cases we're seeing are coming in an airplane from other countries, and cases that aren't completely treated."

Wallace and other health officials spoke at a binational conference on tuberculosis sponsored by the Department of State Health Services, Grupo Sin Fronteras Binational TB Project and Heartland National TB Center in San Antonio.

According to state data, the number of TB cases in Texas has hovered at around 1,500 per year since 2005. But preliminary data for 2008 suggests TB incidence is on the upswing in Texas, Wallace said.

As of Oct. 31, 1,031 TB cases were reported in the state, said Carrie Williams, a spokeswoman for DSHS.

State officials don't yet know how many of these cases were in the Valley.

Health officials said the uptick in tuberculosis could be linked to the state's population growth, as well as increased immigration from Mexico and other countries with high rates of TB.

"Tuberculosis is growing globally," said Eduardo Olivarez, CEO of Hidalgo County Health Department. "Therefore, it's going to affect borders and ports (in Texas)."

Cameron and Hidalgo counties have seen roughly the same number of cases each year, with no strong upward trend, officials said Thursday.
Hidalgo County reported 76 cases in 2007, slightly more than the previous year. Cameron County reported 74 cases, a slight increase from 2006. Willacy and Starr counties typically have a handful of cases each per year.

Like the state, the Valley could see an increase in cases, but it's not certain yet, local officials said.

Tuberculosis investigations, however, have increased "dramatically" in the last couple of years, Olivarez said.

When tuberculosis is suspected, health-care workers must launch a "contact investigation," which involves interviewing and testing family members, coworkers and classmates.

The health department is performing a higher number of investigations because school districts, hospitals and doctor's offices are becoming more vigilant in reporting suspected TB cases, Olivarez said.

Despite the increased vigilance, many Valley residents still aren't aware of the signs of tuberculosis, and patients often put off seeking treatment until they are very ill and contagious, said Dr. Richard Wing, director of communicable diseases for DSHS' Region 11, which includes the Rio Grande Valley. Delays in treatment can spread the disease further, he said.

"There's a lack of education in the general population about the signs of TB and what resources are available," Wing said.

Texas needs more consistent funding for tuberculosis prevention and elimination programs to address these issues, officials said.

"TB isn't as fashionable a cause as other illnesses - it's associated in people's minds with poverty and ignorance," Olivarez said. "But there needs to be more funding to support this cause."