Explore the challenges faced by public health officials in keeping up with the rise of tuberculosis cases due to limited resources.


Brian Lefferts is the Environmental Health and Engineering Director of the Yukon-Kuskokwim Health Corporation in Alaska. In a recent interview, he stated “(Tuberculosis) is a huge challenge. … The state and federal grants have been capped,” he said. “As the needs and the necessities have increased, and the challenges have increased, the funding has remained pretty level and it’s put a strain on all the TB programs.
In Alaska, advocates and medical professionals have been pushing for more state funding for TB control. The agency represents 58 tribes, said the state contributed about $960,000 through a tuberculosis and congenital syphilis prevention grant. “We still have a really large TB problem and so while that’s great, there’s always more that we could be doing,” Lefferts said.
In New York City alone, more than 530 TB cases were diagnosed back in 2022, according to the New York State Health Department. In the event of an outbreak, the agency coordinates with local health departments for contact tracing, screening and testing. Erin Clary, a New York state health department public information officer, said that people who test positive for a TB infection are offered treatment immediately.
Meanwhile in California, health officials provide patient education materials in multiple languages, working with approximately 30 community-based organizations on outbreak prevention and coordinate with local health departments on responses when outbreaks occur.
In Alaska, community testing efforts are limited to focusing on areas with the highest rates; these include Native communities in the southwestern and northern regions of the state. In 2022, Alaska saw 95 confirmed cases, a 64% increase from 2021, as reflected in state health department records.
Although there is a vaccine for tuberculosis, it isn’t recommended for use in the United States because it can potentially interfere with epidermis-based tuberculosis tests, and has only limited effectiveness against pulmonary tuberculosis in adults. Research in developing a new vaccine continues; TB can be difficult to treat due to antibiotic resistance, requiring a multidrug treatment regimen to be effective.
“Treatment gets very serious, because we have a lot of drug-resistant tuberculosis now,” said Dr. Allison Kelliher, a family medicine physician and researcher at the Johns Hopkins School of Nursing and the Bloomberg School of Public Health Center for Indigenous Health.
A person can contract latent tuberculosis, a non-contagious infection that doesn’t show symptoms. This strain can become active and contagious if the immune system should fail to contain it. “[TB] can be insidious,” Dr. Kelliher said. She noted that along with pulmonary TB, there are other types that affect the bones or kidneys.
Commenting on the malady’s disturbing adaptability, Dr. Kelliher mused, “TB can be a great pretender.”
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