NORTHWEST ARKANSAS — Arkansas’ public health agency is changing the way it tests for tuberculosis come Sunday, switching from a TB skin test that produces too many false-positive results and unnecessary treatments.
The state Department of Health plans to use to a newer, more reliable blood test for TB infection, officials said.
The department also is adopting the latest treatment recommendations of the federal Centers for Disease Control and Prevention.
More focused testing is the best way to rid Arkansas of TB, said Dr. Naveen Patil, the agency’s medical director and branch chief for TB, HIV and sexually transmitted diseases.
“Right now, we want to target high risk,” Patil said. “That’s why we are moving away from the skin test.”
“There are too many who are being tested who no longer are high-risk groups,” he added.
Once the leading cause of death in the United States, tuberculosis is a disease resulting from a bacteriumknown as Mycobacterium tuberculosis, according to the CDC.
Symptoms include a bad cough lasting three weeks or longer, coughing up blood or sputum, chest pain, weakness or fatigue, lack of appetite, weight loss, chills, fever and night sweats.
If not treated properly, TB can be fatal. The TB bacteria usually attack the lungs but can target any part of the body, including the kidneys, spine and brain.
“Basically, TB bacteria is in the air,” Patil said. “People inhale it and get infected.”
For most people, the infection will remain dormant - or latent, he said.
According to CDC, a person with latent TB infection has an immune system that has so far allowed them to fight off the bacteria’s growth, so they don’t feel sick or have symptoms, and they cannot spread the infection to others.
An estimated 10 million to 12 million Americans have latent TB infection, said Patil. Of those, roughly 10 percent will develop the disease over their lifetime.
When the TB bacteria become active - in other words, begin multiplying - the person develops TB disease, which means they become sick and can spread the bacteria to those they spend time with every day, according to CDC.
In December, the CDC issued guidelines on treating latent TB infection, said Nikki Mayes, a spokesman for the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention . They can be found at cdc.gov/ nchhstp/newsroom/Latent TBPressRelease.html.
Arkansas’ Patil said that nationally, the old treatment of a daily pill for nine months resulted in roughly 65 percent of patients completing the course. It was less than 50 percent in Arkansas.
The new treatment regime - two pills once a week for 12 weeks - has a nearly 90 percent completion rate that he hopes will benefit Arkansas.
As for the testing, CDC’s Mayes said she found the first FDA-approved blood test forTB came in the early 2000s, with a second approved in 2005. CDC first issued guidance in 2005, with an update in 2010.
Health Department spokesman Ed Barham credited Drs. Joe Bates and William Stead in Arkansas with research they began in 1972 that changed the face of TB treatment in America.
“They were responsible for a treatment that was shorter and outpatient-based,” he said. “As a result, most of the sanatoriums in the country were closed. A very significant development in the treatment of TB.”
Patil added: “There is a vaccination for TB - it’s the most common vaccination in the world.” But it’s not given in the United States because it’s no longer prevalent here.
The Health Department encourages companies with workers who are at high risk for TB to test them.
Tyson Foods Inc. spokesman Gary Mickelson indicated the Health Department changes won’t have much effect on the Springdale-based company.
“Like most employers, we do not screen our workers for TB,” Mickelson said. “On those rare occasions when we become aware of an active case, we work closely with the local Health Department to make sure it’s properly addressed.
“This includes cooperating with the Health Department if additional follow-up testing is needed and helping plan worker training and the distribution of information.”
Northwest Arkansas, Pages 11 on 06/27/2012