New cases of tuberculosis are relatively abundant in Santa Clara
County, prompting one health official to stand behind requirements
to screen all kindergarten-aged children even though a new study
suggests universal testing is a waste of money.
Morgan Hill – New cases of tuberculosis are relatively abundant in Santa Clara County, prompting one health official to stand behind requirements to screen all kindergarten-aged children even though a new study suggests universal testing is a waste of money.
Doing away with universal TB testing for all youngsters would save the state $1.3 million per year, according to a recent study authored by UC San Francisco pediatrics instructor Dr. Valerie Flaherman and the California Department of Health Service.
The report, which was published by the journal Pediatrics, argues health-care dollars would be better spent monitoring people who are at high risk of developing the infectious disease, rather than giving skin tests to all school children. Driving the study’s conclusion is the significant drop in TB cases nationwide in the past few decades, thanks to widespread testing that isolated the germs’ path.
But the drop isn’t as visible in Santa Clara County, where last year there were 228 active TB cases – more than 35 entire states. Additionally, the county led the state in new TB cases.
Health officials say the county’s diverse population and relatively large percentage of foreign-born residents kept the TB rate higher than other jurisdictions.
Nearly 90 percent of TB cases in the county are immigrants from Asian and Latin American countries, where the disease – a bacterial infection that usually affects the lungs – remains a dangerous killer. In 2004, 8.9 million new cases of TB emerged worldwide and 1.7 deaths were reported, mostly in developing countries, according to the World Health Organization.
Given the international presence of the disease and the influx of immigrants to the Bay Area, public health official Dr. Marty Fenstersheib said discontinuing universal testing in the county would cause a health hazard.
“In our county we have a lot of TB, and we know not everyone would be screened if we didn’t require it,” said Fenstersheib. “It’s more of a benefit than a liability” to do universal screening.
Since 1995, the county has required all children entering kindergarten, along with all children transferring from school districts outside of the county, to be tested for TB.
While active TB cases are rare among children, latent cases – where kids carry the TB bacteria but do not develop the disease – can lead officials to infected adults who are more likely to spread the germs to others through coughing, sneezing, speaking or kissing.
A good portion of the county’s TB cases are in South County, he said, but most are concentrated in Milpitas and East San Jose.
