csua.org/u/con -> www.latimes.com/news/local/la-me-tb11jul11,0,5589945.story?coll=la-home-headlines
E-mail story LA Fights to Cure TB One Case at a Time By Solomon Moore, Times Staff Writer The horizon is just starting to glow when Henry Murphy begins his morning rounds, delivering medicine to residents of several local diasporas V ietnamese, Mexican, Guatemalan and Chinese within a few miles of downt own Los Angeles. Murphy winds his white county health department van through some of the p oorest and most crowded neighborhoods in the city.
They are also among the most likely places to find tuberculosis, an infec tious and potentially lethal lung disease that most Americans associate with another era. "Jason started coughing real bad five months ago," 19-year-old Rosie Osor io says, at one of Murphy's stops at a tidy East Los Angeles duplex. "I took him to Kaiser a couple times, but they kept telling me he had a col d" Jason Montanes, Osorio's son, actually has an active case of tuberculosis , all the more serious because he is just 9 months old. He probably caug ht it from his uncle, who had the rattling cough of someone with advance d TB. Like many people from immigrant families, the uncle didn't seek he lp until he was really sick. Now, eight of Jason's close relatives, who live either with him or nearby, are infected, including his mother, his father and his immigrant grandparents. Jason still has a mild cough and is probably still contagious. In the United States, and especially in California, tuberculosis is large ly an immigrants' affliction. According to a recent report by the state' s Department of Health Services, California led the nation in the number of new TB cases reported last year, with 2,989. Three-quarters of those were among people born outside the United States and nearly a fifth wer e younger than 16. Many immigrants, experts say, bring the bacterium from countries, includi ng Mexico, the Philippines, Vietnam and China, where TB is endemic and h ealthcare systems are relatively weak. The infection may lie dormant and noninfectious for years, flaring when a person gets old or his immune s ystem is frail. The disease usually attacks a person's lungs, spreading to others through the air when the person coughs, sneezes, laughs or eve n sings. Family members and others in prolonged contact are most likely to be infected. Although TB has been declining for more than a decade in the United State s, experts worry about how entrenched it remains in some immigrant encla ves. They worry, especially, about a small but stubborn share of cases 1% to 2% in this state that are resistant to standard antibiotics. A study last month in the Journal of the American Medical Assn. found tha t foreign-born residents accounted for eight in 10 cases in California t hat were resistant to multiple drugs. It was immediately incorporated into the emotional debate over illegal im migration. "If anyone needs another reason to oppose illegal immigration," conservat ive syndicated columnist Cal Thomas wrote about TB-infected migrants las t month, "how about the spread of a deadly communicable disease?" "Just because somebody has TB doesn't mean they're a bad person," said Dr . Alan Kurz, a Los Angeles County Department of Health Services medical director for Hollywood, downtown Los Angeles, Pomona and Monrovia. "Peop le with TB contribute to the workplace and churches and social organizat ions like everybody else. With its large immigrant population and dense neighborhoods, Los Angeles County is a TB stronghold. It had 930 tuberculosis cases in 2004, more t han most states, according to health department figures. Murphy and his colleagues fight this ancient, international scourge every day, one patient at a time. As Lau reaches for the pills, a shallow cough sputters from his lips. Mur phy retreats a couple of feet and turns his head away. "I don't know how I got it," says Lau, a lithe man with gray eyebrows, wh o immigrated to the US in 1976.
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