TUBERCULOSIS: Minnesota statistics

In the late 1990s, tuberculosis cases in Minnesota were on the rise, with the number of active cases in Olmsted County more than tripling between 1996 and 1999.So Olmsted County Public Health Services and Mayo Clinic opened the Olmsted County Tuberculosis Clinic as a centralized way to diagnose and treat the deadly disease. Soon, counties across southeastern Minnesota may be able to take advantage of the clinic's expertise.The county recently approved a plan to expand the range of the partnership, allowing the clinic to reach out and admit patients from other counties in the region."It's a hard disease to control, even if you do it properly," said Larry Edmonson, director of the Disease Prevention and Control division at public health. "The whole process of controlling TB is very difficult. But the quicker you get on the case and the more control you have and the more expertise, the more successful you will be in suppression of the disease."Before the TB clinic opened in 2001, hospitals and doctors offices across the county would have to diagnose and treat the disease on their own. Not only was there a lot of overlap, it was often difficult to make a quick, reliable plan for treatment, Edmonson said.By centralizing TB care into one location, they are able to help patients much more quickly and more effectively, he said, because they have staff with experience recognizing and treating the disease all in one place.Public health provides the space, equipment and staff to get a patient started. Then, staff at the TB clinic may send tests to Mayo physicians for quick diagnosis and treatment recommendations. Patients remain at home throughout the treatment, and staff members take medicine to the patients during the week to make sure they stay on track."It's a fantastic relationship," said Timothy Aksamit, a Mayo doctor and medical director of the TB clinic. "Combining the strengths of both partners … allows better patient care in a more efficient way."Centralizing care for TB is particularly important because of how difficult it is to recognize and treat the disease, Edmonson said. Treatment of active TB can last up to nine months and can involve taking four strong antibiotics at the same time.The disease is contagious but usually only spreads to family members and friends in close contact with the infected person, according to Mayo Clinic's website. The clinic does check family members of patients for latent TB and can start treatment to stop the disease before it becomes active.In 2009, 12 cases of TB were treated in Olmsted County, including eight new cases, Aksamit said.Edmonson doesn't expect too many more cases now that the clinic is expanding its coverage area. Most TB cases come from immigrants from countries with higher rates of TB infection than the United States, he said, so most of the problems with the disease are in counties with large immigrant populations, such as Olmsted.Olmsted is working on contacting other counties in the area to see if they would like to start sending suspected TB cases to the Olmsted clinic for diagnosis and treatment, Edmonson said."This is a model that's been very successful," Aksamit said. "It's a very effective way to address a difficult but treatable problem."
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