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Posted: Wednesday, June 20, 2001 12:00 am

Citys TB rate remains high

Health: CDC finds Brownsville is five times the national average.

BY RACHEL BENAVIDEZ

The Brownsville Herald

Despite a recent declaration from the Centers for Disease Control boasting a

record low in reported tuberculosis cases nationwide, state and local

officials continue to track Cameron Countys incidence rate at nearly triple

the national average.

The rate for Brownsville is almost five times the national rate, CDC figures

show.

Local health officials declaring TB the No. 1 border health threat report

17.8 residents per 100,000 in the county were affected by TB in 2000,

including 26.7 per 100,000 Brownsville residents.

TB remains a significant health threat with high rates lingering in

concentrated areas, Jeffrey Koplan, director of CDC, said in a prepared

statement, pointing to the top 10 states with the highest TB rates with Texas

at No. 9.

Tuberculosis, or TB, is spread much like the common cold. It is a highly

contagious airborne disease requiring six months and at least three

medications to cure. If left untreated, it can become resistant to existing

treatments, lead to serious respiratory complications and in some cases,

death.

While the national incidence rate dropped from 6.4 per 100,000 in 1999 to 5.8

in 2000, continuing an eight-year downward trend since the TB epidemic peaked

in 1992, the Texas Department of Healths Region 11 office is noting a slight

increase among 19 South Texas counties.

Even as the overall rates for Texas dropped from 8.2 in 1999 to 7.2 in 2000,

figures for TDH Region 11, including Cameron, Willacy and Hidalgo counties,

rose from 12.5 in 1999 to 12.9 in 2000, despite containment efforts.

You have to keep in mind that its a different picture in different

communities, Marisa Moore, chief of surveillance for CDCs tuberculosis

elimination branch, said. Its not one size fits all.

A customized war plan to combat TB locally was recently outlined by members

of the Healthy Sister Cities initiative, a collaborative effort among local

and Mexican health entities.

Incidence rates have been declining overall because of control and prevention

efforts on both sides of the border, Josue Ramirez, Brownsville Public Health

director, said. Cooperation from Mexican health authorities is our biggest

link to beating this thing because we are right on the border.

There are 23 TB cases on record in Cameron County for the week ending June 8.

More than 120 cases are expected this year in nearby Matamoros, where the

incidence rate is five times as high as it is in the U.S., according to CDC

research.

Extending containment and treatment efforts to Mexican physicians and patients

is often impeded by legal, cultural and language barriers, resulting in poor

identification and continuity of care, local and state officials said.

Our migration patterns, be they associated with economic circumstances,

immigration or travel, have made this challenge more significant, U.S. Rep.

Solomon Ortiz, D-Corpus Christi, said recently.

Ortiz said he is particularly concerned about the border, where heavy

migration, coupled with lack of knowledge, communication and effective

treatment, create favorable conditions for increased incidence.

The CDC estimates 2.7 million people from Mexico and Central America currently

live in the United States without documentation and contribute substantially

to TB morbidity here.

Migratory flow from Mexico, crowded living conditions and limited access to

health care, frequent border crossings, language and cultural differences that

contribute to delays in diagnosis and impede treatment are among the

challenges facing border health officials, a CDC report published January 2001

states.

Attacking the problem from all fronts and both sides of the border is the

only solution, Ramirez said.

Improved communication with Mexican authorities has given us a clearer

picture of the TB population, he said. Now, we can react to those statistics

to control the situation and prevent an outbreak.

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