Texas has one of the highest rates of TB in the U.S. Now, a sweeping effort is underway to diagnose and treat people in South Texas who don’t know they harbor the lung infection.
At San Antonio’s largest homeless shelter, huge fans cool off the temporary residents. The courtyard can get crowded.
One of the hundreds of nightly boarders is James Harrison, 55. "I lost my apartment and had nowhere else to go," he explained.
Like most people at Haven for Hope, Harrison doesn’t plan on staying long. But while he’s here, he’s taking advantage of some free medical testing -- a screening for dormant tuberculosis.
"People don’t even think about TB anymore because you don’t see it anymore," Harrison commented. "There’s nothing that tells you until it’s too late that it’s there."
Tuberculosis is an airborne bacterial infection that attacks the lungs and can be deadly. One vial of blood can be lab-tested to see if people are carrying TB without showing symptoms. That’s called latent tuberculosis infection, a condition that puts them at much greater risk of developing active TB if they are exposed again.
"It goes into your lungs and usually it hides there dormant for years and years. Although it sounds very scary, it is completely treatable," said Barbara Taylor, MD,
an infectious disease specialist who is part of a program called BEST -- Breathe Easy South Texas -- an ambitious two million dollar Medicaid-funded effort.
The Texas Department of State Health Services is teaming up with the San Antonio Metropolitan Health District, UT Health San Antonio and University Health System to screen at-risk people in 20 counties -- an area larger than some entire states. They offer testing at places like shelters, diabetes clinics, low income medical offices.
"It’s not a problem that’s on the south side or east side. It’s a problem all across Bexar County," said Metro Health's Tommy Camden. He emphasized TB does not discriminate. It rears its ugly head in urban and rural communities.
"It doesn’t care what color you are, how much money you make," he added. "As long as you’re breathing, you’re susceptible to catching tuberculosis."
Still, some populations are at greater risk of carrying the TB bacterium: the homeless, diabetics, drug abusers, and people born in other countries. For most people who test positive, the diagnosis of latent TB comes as a surprise. But testing is easy.
"I was kind of scared and nervous at first. But then when she did it, it wasn’t that bad," said a 22-year-Hispanic woman who did not to use her name. She is at the shelter escaping an abusive man.
The young mother may have volunteered the blood sample to earn the McDonald’s gift card she received, but she understands the dangers of TB. "I’ve heard of it. It’s kind of bad," she said.
A third of the world’s population is infected with TB. "
We’ve got some huge challenges ahead of us," Camden stated.
Texas, California, Florida and New York have the highest rates of tuberculosis. Camden said he hopes those states can mimic the BEST program which has screened 3500 people a year. Nine to ten percent had latent TB.
"I am passionate about this because this condition can affect you when you least expect it," said Diana Cavazos, RN, of University Health System. She says those who test positive are given x-rays and a 12-week course of pills, even transportation to the appointments if they need it, free of charge.
"Testing, supplies, treatment, x-rays, it’s completely covered," Cavazos explained.
The Centers for Disease Control has named Breathe Easy South Texas as a TB elimination champion for its efforts that span from Cotulla and Carrizo Springs in the south to Del Rio in the west and Kerrville in the north.
The treatment and testing for hidden TB may be complex, but the goal is simple. Wipe out a killer in our lifetime.
Below is a county-by-county breakdown of testing results.