Experts Say AIDS Partly To Blame for Slowing TB Decline
MIAMI (AP) _ A steady decline in the nation’s tuberculosis rate has stopped this year, and health officials say AIDS is partly to blame.
″Every other year, we’ve had a 6 (percent) or 7 percent decline. This year, it’s not decreasing. The relationship between AIDS and tuberculosis is one reason,″ said Dr. Dixie Snider, director of the division of tuberculosis control at the federal Centers for Disease Control in Atlanta.
″An increasing number of people with AIDS have also been diagnosed as having TB,″ Snider said.
AIDS victims can spread TB to family, friends and health care workers if it is undiagnosed, as is often the case, Snider said.
Three of the nation’s top five areas with increasing TB cases - Florida, New York City and California - also lead the nation for cases of acquired immune deficiency syndrome, he said.
Since the mid-1950s, the only exceptions to fewer annual TB cases were twice when criteria for reporting it changed and once because of an influx of Indochinese immigrants who arrived with it, Snider said in an interview Thursday.
Last year, 22,255 cases of TB were reported nationwide, for a rate of 9.4 cases per 100,000 Americans. While the nation’s rate so far this year remains the same, TB is increasing in some areas.
Since 1977, half the 14,288 diagnosed AIDS victims have died, and the CDC expects cases to rise to 28,000 in the next year. Plus, the 1 million Americans who carry the AIDS virus without showing symptoms of the disease may also have greater odds of getting the TB bacteria, Snider said.
But studies so far haven’t proved the connection between the two diseases and the TB risk for AIDS carriers is unknown, he added.
″The thing we have to worry about are people who share the same airspace with these individuals if they have TB and it’s not diagnosed and treated,″ Snider said. ″Diagnosis is often missed because the appropriate test isn’t used.″
The CDC is studying the AIDS-TB link in Florida and plans a study of New York City’s cases, Snider said.
″If it is documented that people with AIDS are at increased risk, then we have to decide if screening should be done for these people,″ said Snider.
There is no known cure for AIDS. TB can be treated with antibiotics.
Florida’s TB control director, Dr. Clifford Cole, said the state’s slight increase in the illness is mostly in South Florida and often among AIDS patients.
″The two diseases co-exist. We’re seeing more and more cases,″ Cole said.
In Dade County, the TB rate had dropped for four years. This year, it’s rising, said Dr. Janice Burr, who heads the county TB control program.
Miami is home to the nation’s fourth-largest group of AIDS victims and some carry contagious TB, she said.
″Anybody with TB in their lungs can cough up germs. They can pass it on,″ Ms. Burr said. Last year, there were 280 cases of TB in Dade. So far this year, she has seen 310 cases.
TB is thought to develop in AIDS victims because their immune systems are crippled. TB of the lungs is contagious, but TB attacking other body organs may not be, and some AIDS patients have non-contagious TB, she explained.
AIDS, caused by a virus, was first identified in male homosexuals, hemophiliacs and intravenous drug abusers. The virus is transmitted by sexual contact, the sharing of contaminated needles by intravenous drug abusers, and transfusions of blood and blood products.