Threat of TB 'very minimal' for most

CHAMPAIGN — Champaign County has one of the highest rates of tuberculosis in Illinois, but for the average person, the threat of getting this contagious disease is "very minimal," local public health experts say.

The county had seven TB cases last year, or 3.4 per 100,000 people. That was the third-highest-rate in the state behind DuPage County and the city of Chicago.

Many counties in the state, including most of East Central Illinois, didn't have any TB cases, though Piatt and Vermilion counties each had one, according to the Illinois Department of Public Health.

Poised to seek a court order this afternoon to place an uncooperative TB patient in home isolation, the Champaign-Urbana Public Health District says the risk any active TB patient poses to others depends on how they come into contact.

Spread only through the air by an infected person coughing or speaking, TB isn't as easy to catch as some diseases, such as measles and the flu, health officials say.

But unknowns — such as when a person with active TB is going to have a coughing fit — can vary the risk for people who happen to be nearby, according to Candi Crause, director of infectious diseases at the health district.

Say a person with active TB walks into a fast food restaurant, orders food and walks out without coughing: That's not much of a threat to anyone, according to Cause and the district's Nursing Services Manager Jamie Perry. Nor is living in the same apartment building with a TB patient.

The larger risks come from a TB patient who walks into the restaurant and starts coughing with other people nearby, or being in any shared confined spaces — such as the same home, vehicle or work space — with others for extended periods, they said.

One reason Champaign County may have a proportionately higher number of TB cases is that a lot of testing is done in the local community, says the district's administrator, Julie Pryde. The health district does screening at homeless shelters, for example, to try and prevent outbreaks.

"If you don't look for it, you're not going to find it," Pryde says

The county's multi-cultural flavor also has something to do with its TB rate, but that's not because of the University of Illinois, Crause said. Typically most local TB cases are people born outside the U.S. — but they're in the labor force rather than students at the UI, she said, and last year, "the majority of our cases were not foreign born."

Worldwide, TB is the second-highest infectious disease killer, with 95 percent of the 1.3 million deaths in 2012 occurring in poor and middle-income countries, according to the World Health Organization.

People can become infected by breathing in just a few germs, but not everyone gets TB sickness. Some people get a latent infection, which can't be spread to others, and they may or may not become sick with TB later.

Both active and known latent TB cases are treated, but only active TB disease patients are placed in home isolation, according to the local health district. The isolation typically lasts for six-to-eight weeks during a treatment course that runs six to 12 months.

Pryde said the vast number of people who are in home isolation "do not want to infect someone else."

In a 2009 case, in which the local health district also took a defiant TB patient to court to obtain a home confinement order, it took one time for home monitoring equipment to indicate the patient was leaving his home, Pryde recalls. It happened during the early hours of the morning, and she responded with police. After that, the patient complied, she said.

A patient who defies a court home isolation order could be taken to jail or a kept under guard in a hospital room, Pryde said. If Champaign County authorities had to resort to jail to keep a TB patient isolated, they would have to take him to another county facility that has a negative pressure cell to keep the air safe for other inmates, she said.

Pryde reminds everyone public health laws are around for a reason, and they're to keep people safe.

"You cannot relax public health laws," she said.

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