A multidrug-resistant tuberculosis known as MDR-TB is persistent in California, primarily among its “foreign-born” population, and has serious financial implications for the state’s public-health system, federal and state health officials said yesterday.
“Treatment for MDR-TB is very expensive—ranging from $200,000 to $1.2 million per person, over an 18—to 24-month time period,” said Dr. Reuben Granich, a lead investigator for the Centers for Disease Control and Prevention, during a press conference in the District yesterday.
Dr. Granich’s findings were published yesterday in tomorrow’s issue of the Journal of the American Medical Association (JAMA) in an article co-written with California health officials.
The article studied 38,291 reported tuberculosis cases in California from 1994 to 2003. Of those, 407 were classified as drug-resistant and were found mostly in patients from Mexico or the Philippines, Dr. Granich said.
He added that 84 percent of patients infected with MDR-TB “were foreign born” and that those infected are four times as likely to die from the disease and twice as likely to “transmit the disease to others” than other tuberculosis patients.
Cases of tuberculosis, which plateaued in the U.S. after increasing 20 percent in the past two decades, mostly affects the lungs and is spread through airborne bacteria, often through a cough or sneeze. It is considered a global problem, carried in latent form by 2 billion people, or a third of the world’s population, said JAMA editor Dr. Catherine De Angelis.
“Most Americans think TB has been eradicated. If you believe that, then I have a bridge I can sell you,” she said.
In the U.S., almost 15,000 cases were reported last year, with 53 percent of those cases found in foreign-born people. The figure was 29 percent in 1993, according to the study.