Tuberculosis in Alaska is difficult to eliminate

Posted: Monday, June 19, 2000

The following editorial appeared in the Anchorage Daily News:

The tuberculosis bacterium is like the bad guy in a gangster movie. ``You ain't seen the last of me,'' he snarls when hauled off to prison.

The recent outbreak in Anchorage and in villages around Dillingham reminds us once again that we're far from safe from this particular bad guy.

For years, researchers have warned that unless countries with money come up with enough funds to wipe out the disease in poor countries as well as wealthy ones, the world will once again be at the mercy of the tubercle bacillus, and in new, more virulent forms.

The truly isolated country - or state or village - no longer exists. The only way to control TB at home is to control it around the world.

Alaskans have a particular interest. Our neighbor, Russia, is a vivid example of what happens when the fight against TB is weak; the former Soviet Union is a hot zone of drug-resistant TB.

Medical people know how to cure TB. The medication itself doesn't cost much. So why hasn't TB gone the way of smallpox? Because treatment is labor intensive; the only way to make sure a sick person is taking the required drugs is for a health professional to watch the patient actually ingest them.

If the patient feels better and quits taking the medication, then he or she is at risk of developing and spreading TB that is difficult or impossible to cure.

Some perceive the watchful eye of the nurse as an intrusion on their rights. But TB is such a public health risk that treating the individual pales in importance to protecting the public from a disease that without treatment maims and kills and is spread through the air.

Fortunately, not all who are infected with TB develop the disease or are infectious. Also, treatment is so effective that TB-infected people no longer suffer the most serious government intrusion: quarantine.

If life was a movie, then this is when the bad guy invites his next hapless victim to meet him in a dark alley, alone. The audience screams, ``Don't do it! He's going to kill you!'' But inevitably, the hapless victim goes there, and we know what happens next.

Likewise, we have an idea what happens next with TB. Without deploying enough money and medical personnel for an all-out assault on TB around the world, we're blindly agreeing to a date with the bad guy in the dark alley.



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