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CDC HIV/AIDS/Viral Hepatitis/STD/TB Prevention News Update

City Confronts Tuberculosis Outbreak Among Homeless


Associated Press (07.26.03) - Tuesday, July 29, 2003

A tuberculosis outbreak among the homeless population in Maine's largest city has local health officials seeking help from the federal government to deal with the problem. Within the last year, six active cases of TB have emerged, four of them since March.

But Nate Nickerson, who heads Portland's public health division, said getting cured - with drug regimens often lasting at least six months - is not a high priority for some homeless in the city. Health officials have asked Portland's public safety officers and homeless service providers to help locate patients as well as those who may have been exposed and need to undergo TB testing.

Jodi Fickett, a public health nurse, has had to leave her house in the middle of the night to administer medication to a hard-to-find patient who showed up at a shelter. Police have even had to detain a person on the street until she arrived with a vial of drugs. "You want to keep everybody safe, but it's tiring. You're on-call 24-7," said Fickett.

Portland officials report that all six men who developed active TB cases had compromised immune systems due to alcoholism or other diseases. All are getting drug therapy, or have since completed it.

Though TB is on the decline in the United States, some groups - including immigrants from countries where TB is endemic, inmates in correctional facilities, and the homeless - remain at high risk. In Maine, there are about two dozen TB cases a year. Portland officials estimate there to be more than 302 homeless in the city at any given time and about 3,000 over the course of the year.

City officials have requested federal assistance and money to deal with the TB outbreak. The state has helped out, with its health care workers taking on more routine cases of other illnesses so Portland's four-person epidemiological team can focus on stopping the spread of TB.


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Information in this article was accurate in July 29, 2003. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.