One year after a CDC official described a north Florida tuberculosis outbreak as the worst in the nation in 20 years, the state’s Department of Health has declared the outbreak contained and pulled back on a massive public health surge to find and test over 2,200 “high-priority contacts” of contagious sick people.
With its federal grant now expired, the state said it had found around 60 percent of the 2,261 people on the CDC’s high-priority list, a testament to how difficult fighting contagious diseases can be when they strike people who are intermittently homeless, in jail or abusing drugs.
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A disease of the forgotten
The CDC’s team of epidemiologists called north Florida’s TB outbreak the worst in the nation in two decades. Their description of outbreak-related deaths between 2008 and 2011 show it was the forgotten mentally ill, homeless and uninsured who were hardest hit:
- A 52-year-old black woman, history of homelessness, jail stays and drug use; positive for HIV, sick with kidney failure and cirrhosis. … Died two weeks after starting treatment for TB.
- A 59-year-old white man with a history of stroke and homelessness. He died before TB treatment could be started.
- A 46-year-old black man with a history of HIV infection and jail stays.
- A 34-year-old HIV-positive black man lost his job and was forced to discontinue his anti-retroviral therapy. Three months later, he became sick with TB and died a month into his treatment.
- A 19-year-old black woman with no past medical history, but shared a house with two other outbreak cases, sought care only after she developed rising paralysis, a sign her spine was infected with TB.
- A 58-year-old white man with a history of homelessness and mental illness. He died 2 1/2 weeks after starting treatment.
Source: Appendix C, U.S. Centers for Disease Control and Prevention Duval County Epi-Aid Report, April 5, 2012.