Mistrust and Money Swirl in Alabama Tuberculosis Outbreak

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Tuberculosis outbreakMarion, a town in Perry County, Alabama, has a tuberculosis (TB) rate of 253 per 100,000 people, 100 times higher than the 2.5 for the state overall. The outbreak has been going on since 2014 but efforts to track, test, and treat for TB has been hampered by local mistrust and lack of cooperation. It took the offer of being paid to get tested and complete treatment to finally make residents get themselves checked out for a disease that has already claimed three lives so far.

The program in question was launched last week on January 11 and will pay $20 to anyone who comes in to the Perry County Health Department to be tested; it pays another $20 when the person returns after three days to get the result, a final $20 for keeping a chest X-ray appointment if it is recommended, and finally, an entire $100 if a patient diagnosed with TB actually finishes their treatment. About 800 people have received testing since the program started, 47 of whom were found to have tuberculosis.

Currently, Perry County is the only health department in the country that offers walk-in TB testing, due to the severity of the outbreak. In other areas, testing is usually only offered to those who had known exposures due to the normal rarity of the disease.

No one knows where the outbreak began or who patient zero might be. The only thing known for sure is that the cases began sometime in 2014 when cases began to emerge in nearby hospitals, most of which were traced back to Marion. In 2013, only one case of TB was found in all of Perry County and in 2012 there were none at all. Near the start of January, the state health department announced 26 patients with active Marion-linked TB infections.

Locals’ distrust of authorities has hampered efforts to trace and combat the outbreak. In November 2014, after six active TB cases were found in Marion, health officials held a fair to inform and test people. The event had to be shut down after someone threw a bottle at the workers and the police became involved. Residents have also been unwilling to share names of friends with those trying to trace the outbreak to its source and noncompliance with testing and treatment was severe enough to prompt the monetary approach.

Tuberculosis is a bacterial disease that attacks the lungs, but can be cured if identified and treated properly. Symptoms include shortness of breath, a cough lasting more than two weeks, fever, night sweats, weight loss, and fatigue. It is possible to be infected with TB and not show symptoms but still spread the illness to others.

Sources for Today’s Article:

“Perry County, AL: 47 TB Positive Cases,” Outbreak News Today web site, January 19, 2016; http://outbreaknewstoday.com/perry-county-al-47-tb-positive-cases-78459/.
Yurkanin, A., “Investigation of Deadly TB Spreads Fear and Distrust in Alabama Black Belt Town,” AL.com, January 16, 2016; http://www.al.com/news/index.ssf/2016/01/investigation_of_deadly_tb_spr.html.
Yurkanin, A., “Number of TB Infections Jumps to 47 in Marion,” AL.com, January 18, 2016; http://www.al.com/news/index.ssf/2016/01/number_of_tb_infections_jumps.html.