Preventing Disease on Both Sides of the Border

Airborne diseases know no borders. They can be  just a few steps away no matter where we are. Tuberculosis (TB) is no exception and it can get here by car, plane or foot.

The World Health Organization (WHO) declared March 24 World TB Day to highlight the scope of the disease and how to create a world free of the disease.

This infectious, airborne bacterium is especially of concern in US-Mexico border regions, as the rates of TB are higher in Mexico than in the US. The County Tuberculosis Control Program works to detect and prevent the spread of this potentially deadly illness.

For the past 15 years, the County Health and Human Services Agency has been operating a US-Mexico binational tuberculosis referral program called CureTB. The program makes it easier for patients moving between the U.S. and Mexico to manage their disease.

CureTB does this by connecting health care providers in Mexico and the United States and notifying them of a patient’s arrival in their communities. The health care providers exchange clinical information. The program also provides guidance directly to patients and their families on both sides of the border.

“We make the connection before they leave,” said Dr. Kathleen Moser, Director of the County TB Control Program. “We not only talk to their doctor, we talk to the patient.”

When a TB patient from anywhere in the U.S. travels or moves to any part of Mexico, the patient is given the CureTB toll-free number so they can connect with a local doctor or tuberculosis control program in Mexico.

Making sure that a patient with TB finishes treatment—typically six to nine months—is key to prevent the patient from becoming sicker, infecting others or developing a drug-resistant type of TB that can be more virulent and deadly. Resistance to tuberculosis drugs is typically developed when a patient does not remain on appropriate treatment. 

“TB is all about treatment. If you don’t complete it you can get sick again,” added Moser. “It’s in everyone’s interest to make sure TB treatment is completed.”

Tuberculosis is spread from person to person through the air. Once inhaled it can spread anywhere in the body, but it is often silent, causing no harm for many years. Usually only 1 in 10 individuals who get infected with TB go on to develop disease, however if TB occurs and goes untreated it can be fatal.  

WHO estimates that one in three people worldwide have TB infection. With 10 percent progressing to disease in their lifetime, TB is leading bacterial killer worldwide.

Last year, 2,317 TB cases were reported in California; 263 of those were in San Diego County. Only a handful of tuberculosis cases—one to four each year in San Diego—turn out to be drug-resistant.

The County TB Control Program is also working with UC San Diego on a pilot project using technology, rather than a personal visit, to make sure patients are taking their medications.

“If you don’t take your medication exactly right you can make yourself resistant,” Moser concluded.