Immigrants spur return of TB

Immigrants spur return of TB
Once eradicated in U.S., doctors find it difficult to diagnose

Accompanied by the rise in illegal immigration, tuberculosis is making a comeback in the U.S., often eluding diagnosis by doctors who are unfamiliar with the disease.

Though still relatively rare in the U.S., it's a significant problem in states such as California with large numbers of immigrants from countries where the disease is endemic, the Los Angeles Times reports.

TB, one of the most dreaded diseases in the U.S. in the 19th and early 20th centuries, killed more than 1.7 million worldwide in 2004, according to the World Health Organization.

More than three-quarters of the 2,903 cases reported in California last year were among foreign natives, the Times said, noting a total of 14,093 cases in the country.

Tuberculosis is generally treatable if caught early, but the bacteria can remain dormant for years. If diagnosis is delayed, the disease can be deadly and spread to others.

"Delayed diagnosis is a concern that obsesses people in TB control," said Dr. Kenneth Castro, director of the division of tuberculosis elimination at the U.S. Centers for Disease Control and Prevention, according to the Times.

"There are many outstanding physicians who don't see it anymore and therefore lose proficiency to promptly diagnose and treat it."

A recent study in Maryland illustrates the concerns. A look at 158 patients, published last year in the International Journal of Tuberculosis and Lung Disease, showed 45 percent to be undiagnosed 30 days after they first contacted a doctor, with 16 percent remaining so 90 days after, the Los Angeles paper reported.

In response, agencies such as the National Heart, Lung and Blood Institute have helped fund a TB curriculum in medical and professional schools. The Centers for Disease Control in Atlanta has funded national centers providing diagnostic help for doctors.

But diagnosis of TB can be complicated. The commonly used skin test, for example, can only detect a latent TB infection, not active, infectious disease. Follow-up tests are needed, and often a doctor will try TB drug therapy to see of the patient responds.

Dr. Lee Reichman, executive director of the Global Tuberculosis Institute at the New Jersey Medical School, told the Times that when in doubt, doctors should call for assistance.

But "how do you get an arrogant doctor who says, 'I'm a specialist in infectious disease,' who may not be that familiar with tuberculosis, to put down his arrogance and call for help?" he askd.

As WorldNetDaily reported, a border-area mystery infection called Morgellons disease is spreading throughout South Texas at a time when the issues of illegal immigration, border security and possible amnesty for over 12 million illegal aliens are being debated in the U.S.