World TB Day, falling on March 24th each year, is designed to build public awareness that tuberculosis today remains an epidemic in much of the world, causing the deaths of nearly one-and-a-half million people each year, mostly in developing countries. It commemorates the day in 1882 when Dr Robert Koch astounded the scientific community by announcing that he had discovered the cause of tuberculosis, the TB bacillus. At the time of Koch’s announcement in Berlin, TB was raging through Europe and the Americas, causing the death of one out of every seven people. Koch’s discovery opened the way towards diagnosing and curing TB.
In recognition of this increased emphasis on latent TB infection, CDC is proud to feature thirteen CDC U.S. TB Elimination Champions who have been successful in expanding latent TB infection testing and treatment in their communities. Below are just a few of the ways these champions are preventing future cases of TB disease by addressing latent TB infection:
Helping health care providers identify at-risk patients: TB control and prevention has traditionally been a function of state and local public health departments. However, many of those at high risk for latent TB infection and TB disease receive care from private healthcare providers and community health centers, who may be unfamiliar with TB risk factors. Dr. Pennan Barry, from the California Department of Public Health, together with Michael Carson, Program Manager in Orange County, California developed a risk assessment tool and a companion user guide to help clinicians perform risk-based testing. The tool has been shared extensively with community health care providers, and has been downloaded 4,500 times from the California Department of Public Health website since October 2016.
Removing barriers for TB testing and treatment: Healthcare workers and others who work or volunteer in high-risk settings for TB exposure are often required to get tested for TB. The TB Control Team from the Allentown (Pennsylvania) Health Bureau makes it easy for these and other at-risk groups to receive low or no-cost TB skin tests or TB blood tests through their weekly walk-in clinic. Free treatment is offered to those who test positive and are diagnosed with latent TB infection.
Adopting new treatment regimens: One advancement in latent TB infection treatment options is a shorter regimen that combines isoniazid and rifapentine, and is administered once weekly for 12 weeks. Shorter treatment regimens can help patients complete treatment faster and with fewer side effects. Dr. Jonathan Iralu, Chief Clinical Consultant for Infectious Diseases at the Indian Health Service has led the way in adopting this regimen, personally mentoring dozens of clinicians to help bring the latest treatment for latent TB infection to the most remote locales. Under his leadership, the Navajo Nation saw TB disease rates decrease from 23 cases per 100,000 in 1995 to less than 5 cases per 100,000 in 2015.