For Immediate Release:

December 1, 2003

Contact:

Lynelle Phillips

Division of Environmental Health and

Communicable Disease Prevention

573-751-6122

Health Department Issues Advisory on Homeless Shelters and TB

The Missouri Department of Health and Senior Services (DHSS) is advising physicians and other medical professionals in the St. Louis area to screen people with respiratory infections for tuberculosis if they have had a history of homeless shelter use.

“Cold weather is approaching, and homeless shelter use will double or triple in the next several weeks,” according to Capt. Tim Best, The Salvation Army, Harbor Light. “It is important to monitor employees and shelter users for signs and symptoms of TB when a large number of people are spending a substantial amount of time in the same building. Many of these people use more than one shelter, so screening is especially important to prevent transferring health problems from one facility to another.”

Since 2001, there have been 15 active tuberculosis cases among homeless shelter residents in the St. Louis area. Results of disease investigations and laboratory tests indicate that city shelters, particularly the largest shelters, are the likely sites of transmission. The St. Louis City Health Department, the American Lung Association, DHSS, Grace Hill, and The Salvation Army have responded with several strategies to identify cases of TB, including enhanced screening and tracking of shelter users, installation in the largest city shelter of ultraviolet lights that kill TB bacteria, and on-site mobile chest x-ray screening.

“All of the agencies involved should be congratulated for being proactive during the investigations,” said Bryant McNally, director, Division of Environmental Health and Communicable Disease Prevention, DHSS. “As soon as the problem was recognized, these groups worked quickly in partnership to develop preventive steps,” he added.

Tuberculosis is spread through the air. The only way to contract the disease is by extremely close contact, through the air, with someone who has active TB disease. It cannot be spread by contact with someone’s clothing or by eating from the same utensils. Symptoms of TB may include a cough of longer than three weeks, unexplained weight loss, night sweats, chills, fever, and coughing up blood in advanced cases.

There is only one way to know if you have been infected with TB. It is a test called a PPD or Mantoux test. A small amount of test solution is injected under the skin of the forearm. If a person has been infected, there will be a reaction in a couple of days. People who react to the skin test have TB infection. Most people with positive skin tests do not have active TB disease; they have no other symptoms, have completely normal lungs and are not contagious. Physicians determine whether a person has TB disease through further testing, a chest X-ray, and bacteriological analysis.

TB is treatable and curable if it is diagnosed in time. The antibiotic treatment is provided free of charge to anyone in Missouri who is diagnosed with TB disease or infection.

Missouri had 136 cases of tuberculosis disease in 2002, the lowest number since the state started keeping good records in 1944. That is a decrease from 157 cases in 2001 and 211 in 2000. The number of TB cases in the United States is decreasing, but globally it is still a major problem. Tuberculosis kills approximately three million people worldwide every year, and eight million new cases still occur every year.

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