Tuesday, 3 May 2011

TUBERCULOSIS: NYC: cases hit a record low, but disease targets specific immigrant groups

Kathleen Lucadamo  May 1st 2011,
Health officials say immigrants are bringing the contagious lung disease here from their homelands. Related NewsOfficials: Baby boy's death not from swine fluTuberculosis cases hit a record low in the city, but the disease is still rampaging through Chinese and Ecuadoran communities.

Health officials say immigrants are bringing the contagious lung disease here from their homelands.
Health officials say immigrants are bringing the contagious lung disease here from their homelands.

"The TB we are seeing now is driven by a global epidemic," said Chrispin Kambili, director of tuberculosis control for the city Health Department.
In 1992, the height of the city's TB epidemic, 70% of the cases were in New Yorkers born here. Now 80% of the cases stem from those born abroad.
Doctors suspect the disease is dormant among immigrants until they come to the U.S.
Although a TB test is required for permanent immigration, those who arrive illegally or for school may not get the pinprick exam.
Health officials' priority is early treatment to prevent its spread, but TB often goes undiagnosed because the sufferers are poor, undocumented or leery of government.
"We've been really good at stopping the local transmission of tuberculosis, but our challenge is to identify new cases quickly," said Kambili.
Typically, immigrants surface in the emergency rooms of public hospitals where they aren't required to pay.
"The patient doesn't really ever get better until they can't take it anymore and go to the hospital," said George Alonso, director of tuberculosis surveillance and treatment at Elmhurst Hospital in Queens.
Misdiagnosis is also common. Doctors at local clinics, believing TB is obsolete, can blame pneumonia or bronchitis until a patient is coughing up blood and complaining of chest pains.
And outreach has been difficult in a bad economy since community groups in hard-hit neighborhoods are holding fewer health fairs, said Alonso.
Sunset Park in Brooklyn leads the city for TB cases, followed by western Queens, which includes Elmhurst and Corona.
Of last year's 711 patients - the fewest in the city's history - 15% were Chinese, 6% were Ecuadoran, 6% were Dominican, 5% were Mexicans and 4% were Bangladeshi.
For 18-year-old Akram of Astoria, a Bangladeshi immigrant who asked that only his middle name be used, TB was an interruption in his senior year of high school.
"They tested all my friends in school. I thought people would mock me but they didn't," he said.
He was homebound for a month until he completed treatment with a full course of antibiotics, key to stopping the disease from spreading and becoming drug-resistant.
Akram had passed the Immigration Bureau's test, but when the chest pains and fever came on, he knew it was TB because his twin had it two years earlier in Bangladesh.
"I'm glad I caught it early," said the teen, who was diagnosed at Elmhurst Hospital. "People used to suffer a lot."
http://www.nydailynews.com/lifestyle/health/2011/05/01/2011-05-01_tuberculosis_targets_immigrants_city_rates_low_but_ecuadorans_chinese_suffer.html#ixzz1LJcMVxi2

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