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Fla. Surgeon General Unveils New Tuberculosis Protocol

Florida health officials have released new guidelines for monitoring and treating tuberculosis, with the goal of cutting Florida’s TB rate in half over the next 8 years. They say the new plan is necessary because the state’s only hospital dedicated to TB treatment, A.G. Holley, in Palm Beach Co., recently closed due to budget cuts.

The hospital had been treating people with TB for 60 years, but its last patient left on July 2, as the shrinking Florida Department of Health budget forces it to close. Some health officials have questioned the state’s decision to shut down the facility after a tuberculosis spike among the homeless population of Jacksonville. But state Surgeon General John Armstrong, who leads the health department, says the closure is actually an advance in the way the state handles the rare but deadly disease because dedicated TB hospitals aren’t needed in the modern era.

He says, “A.G. Holley is the last tuberculosis sanitarium in America. How is it that the other 49 states figured it out sooner?”

He says, instead of patients having to go to a central facility, they’ll now be able to receive treatment in their own communities, sometimes while being isolated in special housing. Armstrong outlined his new strategy on Monday.

He’s calling for county health departments to monitor potential TB carriers and provide most of the treatment for patients. In the most severe cases, the state health department and national Centers for Disease Control can intervene.

Tuberculosis is a bacterial infection that usually attacks the lungs and causes weight loss, coughing and flu-like symptoms. It can be transmitted through the air in droplets.

Armstrong says, overall, the new plan is about more efficient communication among different agencies and being able to better measure the effects of their efforts. And, the newly appointed surgeon general says, it’s something he plans to use in fighting other diseases too.

“This is a model for what we will implement in other programs across the department of health," he says.

A CDC report from April of this year showed that 13 people in Jacksonville had died after catching a type of TB that infected at least 70 people since 2004. But Doug Holt, medical director of the state’s TB control program, says the new protocol has nothing to do with that spike in Duval County, and media reports have exaggerated the threat. 

“There is no outbreak in Florida. This is not a Duval response. We are just doing the public health job that we do every day," Holt says.

Even with the Jacksonville cases, the statewide TB rate has been steadily declining since 2007. And preliminary numbers halfway through 2012 show the state on track for another rate decrease.

This story was an update to a previous post, below:

The Palm Beach Post broke the story of Florida's hidden tuberculosis outbreak on July 8. The paper reported that, as the Centers for Disease Control were warning of a significant and mostly un-contained TB problem in Florida, state lawmakers were cutting the Department of Health budget and were expediting the closure of A.G. Holley State Hospital in Lantana, which was the only facility dedicated to treating advanced TB cases.

This past weekend, the Post reported on how the outbreak can be traced back to an assisted living facility in Jacksonville. It questions whether conditions at the state's assisted living facilities continue to foster the unchecked spread of the deadly disease. The report attributes the outbreak to a combination of unsanitary conditions and lack of regulatory oversight.

Today at noon, the state Surgeon General, Dr. John Armstrong, medical director for the state TB control program, Dr. Doug Holt and TB expert, Dr. David Ashkin will talk about the situation with members of the press.