California manhunt for tuberculosis-positive patient

[snagglepuss]

Source: BBC News

Authorities in California are searching for a fugitive homeless man who has refused treatment for tuberculosis and may be contagious.

snip

"We need help getting him in," San Joaquin County public health officer Dr Alvaro Garza told US media. "We've not been able to find him in places he's told us he's going to be."

snip

It is currently unclear if Mr Cruz is contagious, but he has not completed a nine-month course of medicine required for treatment.

Tuberculosis - spread through air when an infected person sneezes or coughs - can be fatal if left untreated.


Read more: http://www.bbc.com/news/world-us-canada-28490546

[HockeyMom]

1. A coworker's wife had TB back in the 70s

We were over their house a lot and even went on vacation with them. Yes, she went for treatment when she found out, but WE DIDN'T, and were never tested for it. Oh, no, maybe my husband and I are still carrying that around from 40 years ago??????

[enlightenment]

2. It can sit in your lungs for years.

Not many people with latent TB develop the active disease. You might want to get a TB tine test, just to check.

[HockeyMom]

4. I have working in public schools and with agencies for the MR/DD

but my husband working in business never has.

[enlightenment]

5. I think it's a good idea for everyone.

I grew up a military brat and we had yearly TB tine tests (Japan, 60s and early 70s). I didn't realize until my dad retired that it wasn't a common test.

[du_grad]

10. Probably would not be a bad idea to mention this to your doctor.

If you were exposed way back when, your tine test will still be positive. Another skin test that is a bit better than the tine test is a PPD. They can do a chest x-ray to see if there is a problem. Chances are if you had an exposure, your lungs walled off the organism and you'll be fine. The problem is that, if you ever have chemotherapy (which has an effect on your immune system) this can cause problems, as it did with another gentleman's wife on this thread.

I am a medical technologist who works in clinical microbiology and have for nearly 40 years. We handle the actual specimens and process them to grow out TB.

There is more information here on Diagnosis and testing for TB.

http://www.cdc.gov/tb/topic/testing/default.htm

[Red State Rebel]

3. My daughter was given TB by her babysitter at age 2

They never did find out where the babysitter got it - it is HIGHLY contagious in adults, not so in children. Lori underwent a year of treatment by prescription medicines and did fine. It wasn't fun - had to report to the health department monthly.

[dembotoz]

6. tb pretty much killed my wife

yes she did have leukemia.... but the a typical tb that showed up when her immune system was removed during chemo pretty much did her in.
The strain was not common and by the time they came up with the antibiotic cocktail to treat it the damage was pretty much done.

because of the infections that came along with the treatment, bone marrow transplant was rules out as an option.

I did not understand it at the time, but that signed her death warrant . Just as sure as rick perry signing a death order in texas. that chick was toast

[babydollhead]

7. I'm sorry about your wife. n/t

[du_grad]

11. I am so sorry about your wife

Unfortunately, patients treated with chemotherapy, which messes with your immune system (and also patients with HIV as a co-morbidity) can contract TB and other mycobacterial pathogens easily. M. tuberculosis (the causative agent of TB) is not the only mycobacteria that can cause problems. The two other ones are Mycobacterium kansasii and M. avium-intracellulare (also called MAI). The latter one is a huge problem with patients who are infected with HIV, but can also be contracted by others who are immunosuppressed for other reasons (hemodialysis patients, diabetics, etc. come to mind).

The mycobacteria have a waxy cell wall, which makes them particularly impervious to antibiotic treatment. Indeed, these organisms are called "acid fast" due to the fact that you need nasty chemicals to even break down the cell wall so you can stain them and plate them out! This characteristic is what made the search for antibiotics to treat TB take many many years. Unfortunately, not a lot of new drugs to treat TB have come down the pike since the 1950's, when people thought that the disease was somewhat controlled (ha ha). When the AIDS epidemic hit in the early 1980's, it proved to the infectious disease docs that a whole new ball game was going on.

I am a clinical microbiology technologist working in the field since 1974.

This page has some more information about this organism.

http://www.cdc.gov/tb/publications/faqs/default.htm

[magical thyme]

8. just swell -- a resistant strain to boot.

"Health officials are concerned he may be infected with a drug-resistant strain of the illness."

[CountAllVotes]

9. Not good!

Even though TB is a treatable illness (unless it is the drug resistant strain), it is no joke. In the past there were no great treatments for it.

I found out that about half of my family died from this disease, relatives I never knew existed! TB knows no boundries. Regardless of who they were, the TB killed them.

As for the "patch" test, that can be deadly if the person that receives it is allergic to it as was the case with a friend. His arm swelled up to be a huge painful limb and he suffered badly for a long long time.

In the meantime, I hope they find Mr. Cruz soon.

[du_grad]

12. Here is some information on MDR and XDR TB

http://www.cdc.gov/tb/topic/drtb/default.htm

[CountAllVotes]

13. Thanks for the info.

These people I mention (may they all RIP) died from the mid/late 1800s to as recent as the mid-1940s.

Really sad -- probably lost over close to a dozen relatives from TB.

[du_grad]

14. You're quite welcome.

Streptomycin was the first drug discovered that could treat TB in the 1940's. Unfortunately the organism mutated quickly and they found out that Streptomycin had to be doubled up with another anti-TB antibiotic a few years later.

I found this interesting link to a woman's diary from the 1940's, where she describes how they treated TB before Streptomycin therapy. There was a TB sanitorium near our house back in the 1950's but I believe it was closed in the 1960's. Shows how far we've come from those days.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1079536/

Before Robert Koch discovered the organism that caused TB in the late 1800's, fully a third of the world's adult population was infected with the organism. All of those did not have active TB but had the POTENTIAL of having active TB, given the living conditions and health of whoever was infected. Crowded conditions and poor nutrition enable the spread of this disease. It is much more prevalent outside the U.S. than most people realize.

[CountAllVotes]

15. Oh yes, those sanitariums ...

One of the people that died was my great grandfather in 1929. This was before the stock market crash in October of that year. He was a prominent/well know businessman in San Francisco at that time.

He was placed in a sanitarium somewhere but where? I never really knew but one day I was out with my family on a picnic and we passed this place. It was a shut down place that was very dreary and creepy looking (in the East Bay of San Francisco) and it seems that it was an old T.B. sanitarium (this was abt. 1965 or so) -- in fact the one that my great grandfather was in for awhile!

It seems he did not improve at all there and my great grandmother missed him a lot so he ended up returning home and died not long after that.

I suppose in the 1940s they had a some treatments available as you point out, but the cases I have knowledge of were more of the sanitarium for T.B. treatment method which seems to have not been very effective sadly.

Thanks again for your information. Very helpful!

[du_grad]

16. Sanitariums are about all that were available back then

I posted that diary article on my Facebook page. I have a FB friend who is a pathologist in his mid-70's. He remembers the sanitariums being around in the 1950's. He said that before antibiotics for TB, the average stay was seven years and 1/3 of the patients died.

He also said this (I have to look up this book):

"Thomas Mann's "The Magic Mountain" (about 1924) is a classic account of life in a san. The southern Appalachians once had large numbers of them, where patients were made to sleep miserably in the cold mountain air. Thomas Wolfe's mother was proud that in her Asheville NC boarding house she did not take "tuberculars".

Poet Sidney Lanier (1842-1881) died miserably in such circumstances near Brevard NC."

I believe that TB was near the top as to causes of death in the year 1900.

[KamaAina]

17. Busted!

http://www.sfgate.com/news/science/article/California-tuberculosis-patient-found-arrested-5654129.php

Eduardo Rosas Cruz, 25, was arrested late Monday in Kern County, San Joaquin County Deputy District Attorney Stephen Taylor said. Before Rosas Cruz can be sent back to San Joaquin County, he has to be medically cleared, which could take weeks, Taylor said.

Authorities last week obtained an arrest warrant for Rosas Cruz, saying he was diagnosed with tuberculosis in March after going to San Joaquin General Hospital's emergency room with a severe cough....

Rosas Cruz is a transient and comes from an area of Mexico known for a drug-resistant strain of TB, authorities said....

Taylor said the goal of prosecuting a tuberculosis patient through the criminal courts is not to punish him, but to protect the public. He said Rosas Cruz refused to cooperate with officials.

[KamaAina]

18. Holy $#*! It's happening again, this time in Santa Barbara.

http://www.sfgate.com/news/medical/article/Arrest-warrant-issued-for-Santa-Barbara-TB-patient-5705987.php

A Santa Barbara man with a contagious case of drug-resistant tuberculosis was wanted on an arrest warrant Friday so he can complete treatment, health officials said.

Agustin Zeferino, 24, discontinued treatment for the disease two weeks ago, Santa Barbara County Health Department officials said. Zeferino poses a serious health risk to anyone who comes in contact with him, the department said.

"We do everything we can to enable and give patients incentives to be compliant with receiving treatments," said Charity Thoman, the tuberculosis controller for Santa Barbara County. "This is the most dangerous form of tuberculosis and it can be life-threatening if it goes untreated."...

It is the second time in the past month that California health officials issued a warrant for a TB patient refusing treatment, though the move is extremely rare. Eduardo Rosas Cruz, 25, was arrested last month in Fresno after refusing treatment.

[snagglepuss]

19. Damn. I'm unpleasantly surprised that

"by law, health officials can't force a patient to be treated for tuberculosis, but officials can use the courts to isolate the patient from the public. That is when officials offer treatment."


I would have thought with anyone with a contagious and drug-resistant disease could be forced into treatment. I think that law should be changed, pronto.

[snagglepuss]

20. .

[flamingdem]

21. Any idea what part of Mexico has this problem?

I imagine there are efforts taking place there..