Published: Sunday, August 8, 2010
County to spend $105,000 to keep virulent TB strain in check
The cost of treating the first two patients in Snohomish County with multidrug-resistant tuberculosis is expected to hit $105,000 by year's end, public health officials say. virulent
Two Snohomish County patients were diagnosed with the most severe form of tuberculosis in April, one of five such cases reported in Washington state this year.
Multidrug-resistant tuberculosis is a type of the disease that takes longer for people to recover from and is more expensive to treat.
Money for treatment of the patients comes from a special $250,000 health district fund set aside this year for tuberculosis emergencies.
"What we're trying to do is treat a disease that is communicable that can have serious consequences, including death," said Dr. Gary Goldbaum, health officer for the Snohomish Health District.
Citing privacy concerns and the stigma associated with the disease, the health district has declined to disclose the age and gender of each patient. They have confirmed that two patients are not related.
The disease is not spread through casual contact, generally taking prolonged exposure in a confined space to spread to another person.
The health district has talked to dozens of people who had contact with the two patients, but so far, no other cases of multidrug-resistant tuberculosis have been discovered.
The largest single expense in battling the disease was hiring an additional public health nurse to help care for the patients. Pay and benefits for the nurse, who was hired in July, is expected to hit about $64,000 by the end of this year, Goldbaum said.
The remainder of the expenses help pay for medications, lab tests, and food and supplies for the patients, since they must remain isolated to prevent the disease from spreading.
For example, during the first three months of their treatment, the public health agency spent $2,380 for the medications required to combat the disease.
Nurses must visit the patients twice each day to monitor their condition and make sure they take medication exactly as prescribed. If they don't, the patients could die from the disease or spread it to others.
The two Snohomish County patients have been taking their pills as required -- two times each day -- and are responding to treatment, Goldbaum said. They may have to remain on this regimen for a total of 18 to 24 months.
Patients with multidrug-resistant tuberculosis can be hesitant to take their medication because it can cause severe side effects, such as stomach and digestive tract problems and headaches. "It's a pretty wide range of effects," Goldbaum said. "Almost every organ system can be affected."
It's too early to know how long the two patients may have to continue to be monitored and treated next year, Goldbaum said. The patients will be treated until they no longer have evidence of the disease in the fluids from their lungs, he said.
Although having nurses go to a patient's home and watch them take their pills makes it an expensive way to combat the disease, it has also been shown to be very effective in stopping its spread, said Tim McDonald, who oversees the health district's communicable disease division.
In addition to ensuring the patients take the medications as prescribed, nurses monitor the patient's mental health. The medications sometimes cause psychological problems, such as depression, McDonald said.
The World Health Organization reports that about 500,000 cases of multidrug-resistant tuberculosis are reported each year. "This is a global epidemic," said Joseph Aharchi, who heads the health district's tuberculosis program.
About 62 percent of these cases are found in three countries: China, India and Russia, he said.
The cure rate for global cases of multidrug-resistant tuberculosis is about 50 percent to 60 percent, he said, far lower than for the more common type of tuberculosis.
Sharon Salyer: 425-339-3486 or salyer@heraldnet.com
Snohomish Health District
http://www.snohd.org/
Two Snohomish County patients were diagnosed with the most severe form of tuberculosis in April, one of five such cases reported in Washington state this year.
Multidrug-resistant tuberculosis is a type of the disease that takes longer for people to recover from and is more expensive to treat.
Money for treatment of the patients comes from a special $250,000 health district fund set aside this year for tuberculosis emergencies.
"What we're trying to do is treat a disease that is communicable that can have serious consequences, including death," said Dr. Gary Goldbaum, health officer for the Snohomish Health District.
Citing privacy concerns and the stigma associated with the disease, the health district has declined to disclose the age and gender of each patient. They have confirmed that two patients are not related.
The disease is not spread through casual contact, generally taking prolonged exposure in a confined space to spread to another person.
The health district has talked to dozens of people who had contact with the two patients, but so far, no other cases of multidrug-resistant tuberculosis have been discovered.
The largest single expense in battling the disease was hiring an additional public health nurse to help care for the patients. Pay and benefits for the nurse, who was hired in July, is expected to hit about $64,000 by the end of this year, Goldbaum said.
The remainder of the expenses help pay for medications, lab tests, and food and supplies for the patients, since they must remain isolated to prevent the disease from spreading.
For example, during the first three months of their treatment, the public health agency spent $2,380 for the medications required to combat the disease.
Nurses must visit the patients twice each day to monitor their condition and make sure they take medication exactly as prescribed. If they don't, the patients could die from the disease or spread it to others.
The two Snohomish County patients have been taking their pills as required -- two times each day -- and are responding to treatment, Goldbaum said. They may have to remain on this regimen for a total of 18 to 24 months.
Patients with multidrug-resistant tuberculosis can be hesitant to take their medication because it can cause severe side effects, such as stomach and digestive tract problems and headaches. "It's a pretty wide range of effects," Goldbaum said. "Almost every organ system can be affected."
It's too early to know how long the two patients may have to continue to be monitored and treated next year, Goldbaum said. The patients will be treated until they no longer have evidence of the disease in the fluids from their lungs, he said.
Although having nurses go to a patient's home and watch them take their pills makes it an expensive way to combat the disease, it has also been shown to be very effective in stopping its spread, said Tim McDonald, who oversees the health district's communicable disease division.
In addition to ensuring the patients take the medications as prescribed, nurses monitor the patient's mental health. The medications sometimes cause psychological problems, such as depression, McDonald said.
The World Health Organization reports that about 500,000 cases of multidrug-resistant tuberculosis are reported each year. "This is a global epidemic," said Joseph Aharchi, who heads the health district's tuberculosis program.
About 62 percent of these cases are found in three countries: China, India and Russia, he said.
The cure rate for global cases of multidrug-resistant tuberculosis is about 50 percent to 60 percent, he said, far lower than for the more common type of tuberculosis.
Sharon Salyer: 425-339-3486 or salyer@heraldnet.com
Snohomish Health District
http://www.snohd.org/
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