California public health authorities delivered excellent news recently when they announced that the number of tuberculosis cases reported in 2009 had dropped by the largest margin in nearly a decade.
The number of cases fell to 2,472 – from 2,695 in 2008, and almost 3,300 at the start of the decade, according to the California Department of Public Health.
The decline is a testament to hard work and foresight on the part of county public health officers across California and at the state level.
But there are warning signs. Gov. Arnold Schwarzenegger’s administration has held funding steady at $8.2 million this year and in the coming year.
The bulk is earmarked for counties where the hard work combating the disease takes place. But cash-strapped counties are having a hard time keeping up with spending demands.
The state is providing $566,788 to Sacramento County this year, plus additional money for housing and related medical needs. The county provides the rest of TB program spending, $3.7 million. That is down by almost $840,000 from the prior year. A similar cut is contemplated in the coming year.
Such cuts take a toll. Consider the rebound of syphilis. At the end of the 1990s and the beginning of 2000, there was a realistic hope that syphilis would be relegated to history. As a result, money to combat it was cut.
An outbreak in prison spread it outside the prison walls. In time, it jumped to heterosexuals.
In 1999, Sacramento County recorded two cases of syphilis, and one in 2000. By 2008, there were 91 cases, up from 62 the year before.
Lately, Sacramento County public health authorities have identified pregnant women who have the disease. That poses a serious threat, since syphilis can cause a variety of birth defects and mental retardation.
The fight against communicable disease is labor-intensive. Public health officers must follow individuals with tuberculosis to make certain they do not spread it and are taking drugs to cure it.
California leads the nation in reported tuberculosis cases, with roughly 1,000 more than the next nearest state, Texas. Although the disease is a problem among certain immigrant communities, infectious disease knows no boundary or class.
Tuberculosis spreads when infected people cough or sneeze. It usually attacks the lungs and generally is treatable, although at least 197 people died of it in California in 2008.
State and county officials who control funding must understand that even in tough budgetary times, cuts in public health produce false savings. As the re-emergence of syphilis shows, communicable diseases that once appeared to be under control have a habit of reappearing.