Mar. 14--While tuberculosis continues its steady decline in California, it spiked last year in four Sacramento-area counties for reasons that aren't fully understood.
Random fluctuations and changing demographics both could underlie the numbers in Sacramento, Placer, Yolo and Yuba counties, several health officials said Thursday.
What's clear, however, is that with the developing world harboring so many potential cases of TB, the disease can't be successfully fought within any one country's borders, said Placer County community health director Mark Starr.
"In today's world, there's no sense in pointing fingers. We should be solving problems," Starr said.
The bacterium that causes TB is widespread worldwide, although it usually stays inactive in most healthy people.
When people age or their immune systems are compromised by cancer, diabetes or other diseases, tuberculosis can become active. It most commonly attacks the lungs and can spread to other people when the infected person coughs or exhales.
That's where public health officials step in, testing for TB and treating it, and insisting that infected people be isolated.
One TB sufferer who violated a health order to stay away from others is currently jailed in a Sacramento County isolation cell with special air-handling equipment, said county public health officer Dr. Glennah Trochet. She declined to give further details on the case.
While Sacramento County's reported TB cases are up from 97 in 2006 to 110 last year, it's too soon to know whether that's a trend, health officials said.
The county's other upswings over the past decade were TB outbreaks, when many cases could be traced to the same source, but there were no outbreaks in 2007.
"At this point, we can't explain it," Trochet said. "We have to watch this closely" to see if a pattern emerges in coming years.
TB can be lethal if untreated, Trochet added, and finishing the full course of treatment against the disease has become especially important as more drug-resistant strains emerge.
In Yolo County, the surge in 2007 to nine cases, from three the previous year, represents a normal variation, said public health officer Dr. Bette Hinton. And Placer County's Starr believes changing demographics explains his county's near doubling, from six to 13 cases.
Placer County has never had much tuberculosis, and it still doesn't. Its rate, at four cases per 100,000, puts it 24th among the 61 reporting jurisdictions in the state.
In 2007, just three of the people being treated for TB in Placer County were born in the United States, and they all caught it from close contact with a person born overseas, Starr said. The other 10 sufferers came from Myanmar, Guatemala, Mexico, Nepal, the Philippines, South Africa and South Korea.
Statewide, about 76 percent of tuberculosis cases occurred in people born outside the United States, according to statistics posted online by the state Department of Public Health.
For years, the overall number of cases statewide "has been going steadily down," said Dr. James Watt, acting chief of the department's TB control branch. That's due largely to effective county health operations that work to detect new cases, treat them and prevent more by reaching out to those potentially exposed, Watt said.
County-by-county variations are more complex, he said, and no single pattern emerges to explain why some are up and others are down.
Meanwhile, the American Lung Association of California called Thursday for more funding to prevent the spread of TB.
The group opposes Gov. Arnold Schwarzenegger's proposed budget, which would lop 10 percent off the $9.5 million allocated in fiscal 2007-08 to help fight tuberculosis, said association spokesman Andy Weisser.
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