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TB Outbreak in Kansas' Homeless Difficult to Track

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Local and federal health officials have finished their investigation of a tuberculosis outbreak among homeless people in Wichita, Kan.

Now they're faced with the tough part of the task -- making sure that those with the disease take their medicine for the next six to nine months.

A four-person team from the federal centers for disease control and prevention was in Wichita recently to help with the investigation, which involves tracking people with TB and the people with whom they've had contact, and getting them started on medication.

Health officials found about 30 people with active TB, said physician Doren Frederickson, who is Sedgwick County's health officer.

Tuberculosis, a disease caused by a bacterium, usually affects the lungs but can affect any part of the body. Having TB means the bacteria are active in the body and can be spread to others. Symptoms include a cough, a fever, weight loss and night sweats.

A person also can carry a dormant form of the bacterium; his skin test will show up positive though he may never have symptoms and can't infect others.

Homeless people are one of the groups at high risk for tuberculosis infection because of their close living quarters, which commonly are poorly ventilated. TB is spread through the air. Many homeless people are substance abusers, which increases the chance that infection will progress to disease.

Tuberculosis is treated with medication that must be taken daily for six to nine months. Treating it is labor-intensive because health department nurses must give the medication in person, to make sure that it's taken.

People with positive skin tests but no symptoms can be given medication, too, if they are at risk for developing active disease.

The TB rate nationally has been dropping and is at a low, with 5.2 cases per 100,000 people. The rate is even lower in Kansas -- 3.3 per 100,000 -- but has increased in recent years. About a third of the Kansas cases last year were in Sedgwick County.

The CDC sends in help when state or local officials ask for it, said Kashef Ijaz, chief of the outbreak investigations team in the division of TB elimination. In general, they stay for three weeks or less and provide extra help for local health officials.

A CDC team also was in Wichita to investigate a TB outbreak in April 2001. Several of those cases were tracked to exotic dancers at "gentlemen's clubs" in Wichita.

More recently, a CDC team helped investigate an outbreak of TB among homeless people in Portland, Maine.


(c) 2003, The Wichita Eagle (Wichita, Kan.). Distributed by Knight Ridder/Tribune News Service.

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