Friday 21 September 2012

TUBERCULOSIS: Olive View-UCLA hospital treats severe tuberculosis cases


Published on  by Ted Purlain


Tuberculosis
The Olive View unit of UCLA Medical Center in Sylmar is now one of only four centers in the country specializing in tuberculosis.
“Something that the average physician would only see maybe once in a lifetime, we see kind of routinely here,” Dr. Gleen Mathisen, the director of the infectious disease department at Olive View said of the unit, the Los Angeles Times reports.
The high-tech isolation unit was opened last August and currently serves highly infectious, difficult-to-treat tuberculosis patients. The unit was built as part of a $53 million federally funded renovation of the public hospital’s emergency room to equip it for a bioterrorism attack. The unit has noticed that TB infections are down dramatically but are becoming much more complicated.
“You’re getting to those that are much more challenging to treat medically, that require longer hospitalization,” Dr. Frank Alvarez, the director of the county’s tuberculosis control program, said, according to the Los Angeles Times.
Olive View opened 90 years ago as the largest TB sanitarium west of the Mississippi. The facility now can hold up to 30 patients, offering them a state-of-the-art, pressure-controlled air circulation system designed to keep the airborne disease from spreading. If anything is amiss, an alarm system sounds and UV light zaps the air in the unit, killing any tuberculosis germs.
Tuberculosis was once a common and deadly threat known as consumption, though it is now viewed by many developing countries as a bygone disease. The illness remains widespread, though, in poorer countries and in areas in developing countries with large and diverse immigrant communities. Alvarez warned that it should still be taken very seriously.
In Los Angeles County, cases of TB have dropped nearly 70 percent in the last 20 years, but 680 infections were reported last year, 80 percent of which involved people born in other countries, including Mexico, the Philippines, Vietnam and China.
Olive View takes on the most demanding cases, some of which have caught Mathisen and his colleagues by surprise.
“They’re sicker than we thought they would be,” Mathisen said, the Los Angeles Times reports.
The center also works with patients who are homeless or low income and suffering from conditions that make tuberculosis treatment more difficult, including diabetes, HIV, heart disease, substance abuse or mental illness.
Olive View keeps patients for a few months, giving them the opportunity to be counseled and educated on their illnesses and medications, according to Leona Mason, a nurse practitioner in the ward, the Los Angeles Times reports.
In Los Angeles, approximately six percent of TB cases occur among people with HIV and nearly 25 percent occur in people with diabetes.
Recovering from tuberculosis can be a long process often made more difficult by compounding illnesses or drug-resistance. Treatment can last six months at minimum or up to two years in more severe cases, which may drive the cost of treatment to upwards of $250,000, according to Alvarez, the Los Angeles Timesreports.

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