News Release

March 10, 2000

Houston/Harris County TB Cases at 25 Year Low

Tuberculosis cases in Houston and Harris County in 1999 declined to their lowest levels since 1975.  The Houston Department of Health and Human Services (HDHHS) recorded 456 new cases of TB in 1999, down from an all time high of 786 cases in 1995.  HDHHS has maintained a TB case registry for more than 30 years.  The lowest number of cases registered was 441 in 1975.
     M. desVignes-Kendrick, MD, MPH, HDHHS Director, credits the improvement in TB rates to a dedicated crew of TB specialists.  “The Houston TB Control program initiated and perfected the national standard of care for tuberculosis patients, directly observed therapy.  Their commitment to this treatment strategy is paying real dividends to the residents of Houston.”
     TB patients will normally feel better after two weeks of treatment and tend, like most people taking medication, to not complete their course of treatment.  TB treatment requires six to 12 months of antituberculosis medication.  Failure to complete the six to 12 month course of treatment results in multi-drug resistance.  Multi-drug resistant tuberculosis is much more difficult and expensive to treat.
     Directly observed therapy (DOT) is a treatment strategy where medication doses are delivered to the patient and the patient is observed taking the medication.  DOT doses are delivered daily for the initial phase of treatment, then decreased to two or three times per week.  Patients who have drug resistant disease will continue daily DOT throughout their course of treatment.  Ninety percent of the 1999 TB cases were placed on DOT.  The multi-drug resistance rate for Houston in 1999 was 0.2 percent.
     HDHHS TB Control Program also employs directly observed preventive therapy (DOPT) to patients with latent tuberculosis infection (positive tuberulin skin test), but have not developed active disease.  DOPT utilizes the same strategy as DOT.  DOT and DOPT staff deliver medications on weekends and holidays.  Patients who cannot be located for medication delivery are referred to a special team to locate the patient and return the patient to medical supervision.  As of March 9, 2000, the Program is delivering 1,083 doses of DOT and DOPT per week.
     The HDHHS TB Control staff meets daily to discuss case status and assignments for new TB investigations.  For each new TB case, a contact investigation is initiated within three days and efforts are made to test contacts within a week.
     TB cases began to rise in the 1980's due to declines in funding for treatment and surveillance.  Simultaneous to declines in funding, increases in high risk populations living in congregate settings (prisons, homeless shelters, refugee facilities) facilitated new infections.  AIDS also contributed significantly to rising cases of TB.
     According to Kendrick, “Tuberculosis is the oldest and most resilient killer on earth.  I doubt we will ever completely eliminate it, but the declining numbers we are seeing in Houston are very encouraging.”