New Jersey’s total number of active tuberculosis cases reached an all-time low in 2007, but TB remains a serious health threat that continues to challenge the medical and public health communities, Health and Senior Services Commissioner Heather Howard said today in marking March 24 as World TB Day.

“Partnerships for TB Elimination” is the theme of this year’s World TB Day, which is sponsored by an international coalition including the World Health Organization. 

After the most recent peak of nearly 1,000 cases in 1992, the number of New Jersey’s TB cases declined to 467 last year.  This parallels a decline seen nationally.  But while the number of New Jersey cases has dropped dramatically among those born in the U.S., the numbers have risen among foreign-born New Jersey residents, who now account for 70 percent of all of cases.

          The Department of Health and Senior Services is working closely with the state's established community health centers to identify those individuals with TB infection who have not yet become sick and ensure they get treatment.  Most foreign-born residents at risk for TB already use the health centers as their main source of medical care.

“We have made important progress in the fight against TB, with the hard work and close cooperation of our many partners.  Together with hospitals, private physicians, local health departments and advocacy groups, we will continue this fight until we eliminate TB,” Commissioner Howard said.

The declining TB caseload has meant that fewer physicians have significant experience treating the complex disease, which can require multiple drugs taken for up to a year or more.  There are further treatment challenges when patients have TB that is resistant to multiple drugs, are infected with HIV, or have trouble tolerating anti-TB medications or adhering to their medication regimen.

In 2005, the Department of Health and Senior Services responded by adopting a regional approach to specialized TB care.  DHSS created partnerships with hospitals and private physicians to create and staff regional centers, where TB patients could be referred if needed for expert diagnosis and treatment.

          The regional clinics are located at UMDNJ -- University Hospital, Morristown Memorial Hospital, Somerset Medical Center and the Camden County Department of Health. The Department’s TB Program field staff assists with transportation for patients who can’t otherwise get to these sites.  The regional clinics accept referrals of complicated cases from county clinics, which previously offered the state’s only public health TB diagnosis and treatment services.

          “These regional clinics also offer private physicians important medical and public health services that can lead to effective patient care and the greatest likelihood of cure," said Dr. Eddy Bresnitz, deputy commissioner and state epidemiologist.  “The clinic physicians are experts in this field and a number of them consult widely in other states or through the Global TB Institute in Newark. They can work with private physicians when a patient has complex medical management issues, or will also accept patient referrals.”

          Private physicians can also work through the public health system to obtain nursing, outreach and other services to help their patients remain under medical care and adhere to their prescribed treatments.  Patients who are uninsured or not adequately insured can obtain anti-TB drugs at no charge through the public health system.  Public health also offers case management and contact investigation services.

TB is caused by a bacterium that usually affects the lungs, but can also affect any system in the body.  A person can have a latent TB infection, which means they are infected but not sick and cannot spread the disease.  An infected person can also develop active TB disease, and when the lungs are affected, can spread the bacterium through the air by coughing or sneezing.  Usually, prolonged contact with the diseased person is required to acquire latent TB infection.

Currently, one-third of the world’s population is infected with the TB bacterium, according to the federal Centers for Disease Control and Prevention.  There are nine million new cases of TB reported annually, resulting in 1.6 million deaths worldwide.

An estimated nine to 14 million people in the U.S are infected, and without treatment, five to ten percent of them would be expected to develop active TB during their lives.  Health conditions such as HIV infection or diabetes make a person more likely to develop TB disease.

After decades of decline, there was a resurgence in TB cases nationally from 1985 to 1992.   This resurgence resulted from a lack of adequate funding and marked the emergence of a form of TB disease resistant to multiple drugs that is difficult and expensive to treat.

Health professionals may call the TB program at (609) 588-7522 to learn more about consultations, referrals and accessing supplemental public health services for TB patients.  For more information about TB, visit the department’s web site at www.nj.gov/health/cd/tbhome.htm.

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