Sunday 17 October 2010

TUBERCULOSIS: Specialised hospital for TB in Texas



After years of delay, a high-tech replacement for the Texas Center for Infectious Disease celebrated its opening Wednesday, touted as the nation's first new tuberculosis hospital in more than 50 years.
But with the future of Florida's aging TB hospital in doubt, state and federal officials noted that San Antonio soon could be home to the nation's last major TB hospital — an artifact of the early 20th century when TB sanatoriums were found across the country. At one time, Texas had 21, San Antonio's the biggest.
“It's easy to forget about tuberculosis,” said Dr. David Lakey, Texas health commissioner. “People forget that one-third of the world's population is infected. They forget that here in the state of Texas, we have about 13 percent of all the cases in the United States.”
While most patients can be treated in the community, the most complicated, drug-resistant cases, or those quarantined because they refuse treatment, often are sent to TCID. Depending on the severity of the disease, patients stay there from three months to two years. The only two known Texas cases of extensively drug-resistant TB — a strain that can be virtually untreatable — were successfully treated at TCID.
“I really had an angel with Texas Center for Infectious Disease,” said Alisha Thomas-Gibbons, who arrived in 2007 emaciated at 89 pounds, homeless and about to give birth to a crack cocaine-addicted baby. The hospital cured her TB, treated her addiction and eventually hired her in a clerical job. She now has her own apartment.
“The primary justification for building this new hospital is the expertise in medical care for tuberculosis patients provided by the TCID physicians,” said Dr. David Griffith, the hospital's medical director. “I believe in my heart that there is no better place in the United States for someone to obtain care for tuberculosis.”
The new hospital, built on the original grounds, features 75 beds in secured rooms, with a sophisticated air-handling system that can adjust the air pressure in each room depending on the isolation level required, and that filters and replaces the air 12 times an hour. Rooms are accessed through anterooms that also adjust air flow in response to changes in air pressure. Even the floor tiles kill germs.
The original hospital opened at 2303 S.E. Military Drive in 1953 as the State Tuberculosis Hospital. Its decrepit condition threatened its accreditation in the early 1990s. The Legislature agreed to rebuild it — first with tobacco settlement funds and later with $20 million in revenue bonds approved in 2001.
But construction was halted as alternatives were considered and lawmakers from other parts of Texas tried to get the hospital moved. In 2007, the Legislature finally released the money. Rising construction costs reduced the size of the project, and some existing buildings were kept for offices and support functions.
Six years ago, one of four federally funded Heartland National TB Centers was located at TCID, offering training and expert consulting to doctors and public health agencies in 13 states.
“We don't really want to be doing this,” hospital administrator Jim Elkins said. “We'd love to work ourselves out of a job, but we can't.”
http://www.mysanantonio.com/health/high-tech_replacement_for_states_only_tb_hospital_opens_103572534.html?showFullArticle=y

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