Tuberculosis Outbreak In Alabama: 3 Dead And 47 Positive Cases Reported With Numbers Rising

Marion, a small city in the state of Alabama, is facing what could be called an outbreak of tuberculosis. This small city with a population of 3,600 has an incidence rate of 253 per 100,000 population, which is 100 times greater than the entire state of Alabama and worse than in many developing countries.

Pam Barrett, the director of ADPH’s Division of Tuberculosis Control, told Alabama Public Radio, “I would say that there are probably not very many towns at all in the United States that have a case rate that high. Why do you think it’s so high? Because of the number of cases that have not shared their contacts and people have not come forward to be screened and be treated preventively.”

There’s only one health department in Alabama where people can go to be tested for tuberculosis. That’s in Perry County, where the outbreak claimed three lives in 2015.

In rural Alabama, a longtime mistrust of medicine fuels a tuberculosis outbreak https://t.co/191Qmay94y pic.twitter.com/O7JIqmKGFi

— NYT National News (@NYTNational) January 18, 2016

Dr. R. Allen Perkins, a former president of the Alabama Rural Health Association, told the New York Times, “There’s not a culture of care-seeking behavior unless you’re really sick. There’s not support for local medical care, so when something like this happens, you have a health delivery system that’s unprepared.”

In Rural Alabama, a Longtime Mistrust of Medicine Fuels a Tuberculosis Outbreak https://t.co/BnxBQpTSrI pic.twitter.com/arN0DIKtbq

— Casey Hinds????? (@CaseyHinds) January 18, 2016

The Perry County Health Department has been offering monetary incentives to area residents for getting tested and undergoing treatment, if necessary, and officials say they will continue to pay for testing until at least January 29.

• $20 to anyone coming in to be screened for TB by the TSPOT blood test.
• Another $20 for returning after three days to get the result.
• A third $20 for keeping an appointment to get a chest X-ray if it is recommended.
• An additional $100 to a patient if it is recommended he or she take medication and
treatment is completed.

LIVE NOW: A history of racism & mistrust is feeding this #tuberculosis outbreak in Alabama. https://t.co/VE6AslLhY2 pic.twitter.com/OEFhJstWGP

— The Takeaway ? (@TheTakeaway) January 19, 2016

According to the Centers for Disease Control and Prevention (CDC), tuberculosis is spread through the air from person to person. Symptoms include a bad cough that lasts three weeks or longer, pain in the chest, coughing up blood, fatigue, and lack of appetite.

Barrett explained to the ABC3340, “The terminology for having the TB germ but not having TB disease is called having TB infection or latent TB infection, that simply means you have the germ in your body that causes TB and at some point in your life you could develop active TB. You may not, but the preventive medicine that we can offer you is sort of like an insurance policy that would protect you from having active TB.”

Widespread poverty, a history of racism, and memories of the Tuskegee incident have contributed to the outbreak. The Tuskegee Syphilis Experiment, an infamous clinical study conducted between 1932 and 1972 by the U.S. Public Health Service, studied the natural progression of untreated syphilis in rural African-American men in Alabama under the pretext of receiving free health care from the United States government. But researchers did not make complete disclosures about their work. The patients were not given penicillin, a recommended treatment after 1947. This added to the mistrust among the people towards public health care systems.

Bennie Royster attended a town hall meeting last week along with about 50 other residents at Francis Marion High School’s auditorium. Alabama Public Radio reports that he hasn’t been tested for TB but she wanted to come to the meeting for a better understanding of the disease.

She said, “When they sent the flyer out paying people to come and be tested, I’m thinking we’ve got something bad going on here. Listening at them tonight, I’m less afraid. And if I were to come down with TB, because I asked this question about the privacy act like they said because we’ve had so many people that have already died in Perry County, I wish I knew the person. Because if I knew the person, then I know to go and be tested.”

Although the Alabama Department of Public Health is taking the necessary measures to curb the tuberculosis outbreak, it will be a long haul considering the nature of the disease and the time of treatment.

[Photo by Media for Medical/Getty Images]