The U-shaped curve of concern: TB returns with a vengeance when programs cut

January 12th, 2015

This one may have slipped under the ID radar a little bit, but it is worth underscoring that tuberculosis is not a vanquished disease relegated to the impoverished in the Third World. It is right here, in Jacksonville, Fl, spreading among the homeless and impoverished in the richest nation on earth.

A ProMED-mail posting from July 2012, indicates public health officials are concerned that an ongoing outbreak of TB remains uncontained and may spread to other parts of the state. Beginning with a single case in 2008, the outbreak has resulted in 99 active TB infections that include six children. Thirteen deaths have been reported .

According to a report in the Palm Beach Post, a Centers for Disease Control and Prevention TB epidemiologist said it was one of the worst outbreaks his group had investigated in 20 years. The outbreak comes amid public health budget cutbacks and the closing of a state hospital that treated TB cases, suggesting TB continues to follow what has been described as the “U-shaped curve of concern.” That is, as the disease declines due to public health interventions, funding for those very programs is subsequently cut. Both TB and “concern” about TB are low, and invariably the disease begins to rise again.