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PO Box 360
Trenton, NJ 08625-0360
|Poonam Alaigh, MD, MSHCPM, FACP|
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Although New Jersey’s rate of active tuberculosis is the lowest in nearly two decades, TB remains a serious public health threat requiring continued vigilance and partnership among public health agencies, physicians, hospitals, researchers and clinics, Health and Senior Services Commissioner Dr. Poonam Alaigh said in marking March 24 as “World TB Day.”
“On the Move Against Tuberculosis: Transforming the Fight Towards Elimination” is the theme of this year’s World TB Day, which is sponsored by an international coalition including the World Health Organization.
“New Jersey is fortunate to have world-class resources for fighting TB. Working with our partners, we’ve reduced cases of active TB by about 60 percent since the early 1990s,” Dr. Alaigh said. “But the fight is far from over. Last year’s 405 TB cases underscore the critical need for all physicians to be alert for possible TB cases and for all of us to renew our commitment to eliminating TB.”
In 2010, 405 New Jersey residents were diagnosed with active TB, the same number of cases as in 2009. These totals were the lowest since the state’s TB incidence peaked in 1992, when there were nearly 1,000 cases. TB has been declining among New Jersey residents born in the U.S. Increasing numbers of cases – 75 percent in 2010 – are being diagnosed among foreign-born residents. This may reflect the increase in New Jersey’s foreign-born population, and the fact that many come here from countries where TB is more prevalent than in the U.S.
Counties reporting the highest active TB incidence in 2010 were Middlesex (65 cases), Essex (54), Hudson (51), Bergen (43), and Union (34).
According to the U.S. Centers for Disease Control, one third of the world’s population is infected with TB, more than nine million become sick with the disease each year, and nearly two million die. TB is a leading killer of people who are HIV-infected.
TB is caused by a bacterium that usually affects the lungs, but can 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 go on to develop active TB disease. When the lungs are affected, the TB bacterium can be spread through the air by coughing or sneezing. Usually, prolonged contact is required to spread the infection. TB symptoms can include a persistent bad cough, coughing up blood, chest pain, weakness, fever, night sweats and/or weight loss.
Drug treatment for TB may take six to nine months. Multi-drug resistant TB (MDR-TB) can require up to two years of treatment. Eight of New Jersey’s 405 TB cases in 2010 were MDR-TB. With the declining number of TB cases in the state, fewer community physicians have experience in the increasingly complex treatment and management of people with TB.
New Jersey has adopted a regional approach to providing specialized TB care. The state has extensive resources to aid in the diagnosis, treatment, follow-up and referral of patients with TB, as well offering education and consultation services to physicians in New Jersey and worldwide.
New Jersey has public health clinics in most counties that provide TB diagnosis and treatment services. The state’s community health centers also play an important role, working closely with the public health system in TB diagnosis, treatment and management.
Every person with TB disease is assigned a nurse case manager to supervise their care. Nearly all TB cases are placed on directly observed therapy to ensure they take all medication doses. This is necessary for successful treatment of the disease and to prevent drug-resistant TB strains from emerging. Nurse case managers also identify the person’s close contacts and arrange for medical evaluation in order to reduce the further spread of TB.
If needed, complex TB cases may be referred to one of five regional specialty clinics at UMDNJ -- University Hospital, the Hudson County Health Department, Morristown Memorial Hospital, Somerset Medical Center and the Camden County Department of Health. Clinic physicians are experts in diagnosing and treating TB, and also consult with private physicians whose patients have complex medical issues.
DHSS also helps fund the Global TB Institute at the New Jersey Medical School – UMDNJ, which has been designated a National Model TB Prevention and Control Center. It offers state-of-the-art treatment, conducts research, and provides consultation, education and training to physicians and health officials. The New Jersey Medical School’s Public Health Research Institute also offers sophisticated laboratory testing to quickly identify TB strains. This aids in patient treatment and in investigating cases that may be linked to the person ill with TB.
On June 15, DHSS will hold the annual New Jersey Statewide Symposium – HIV Clinical Update in New Brunswick. This year’s symposium will feature presentations by experts in the area of TB and STDs in addition to HIV/AIDS.
Health professionals may call the TB program at (609) 826-4878 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 http://www.nj.gov/health/tb/index.shtml.
“Working together, we have made great strides against this potentially deadly disease. World TB Day is an opportunity to recognize our successes while challenging ourselves to dramatically reduce, and some day eliminate, tuberculosis,” Commissioner Alaigh said. “I encourage all physicians to join us in this effort. New Jersey has many excellent resources to draw upon. Our Department’s experts are always available to health providers who need information and guidance.”
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Department of Health
P. O. Box 360, Trenton, NJ 08625-0360