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Nan Rich Calls for Investigation Into TB Outbreak as Florida Surgeon General Fumes

| July 12, 2012

Nan Rich

Nan Rich

Senate Minority Leader and gubernatorial candidate Nan Rich called today (July 12) for the Senate to investigate reports of a tuberculosis outbreak in Northeast Florida as the state closes its last hospital dedicated to treating the disease. Rich, D-Weston, wrote a letter to outgoing Senate President Mike Haridopolos, R-Merritt Island, asking for the probe. “Not only is this exposure a public health threat, but the ability of a state agency to circumvent the transparency which is supposed to govern our legislative process is troubling at best,” Rich wrote. “The bottom line is that the public was not made aware nor were lawmakers, including myself, tasked with making programmatic and fiscal decisions about public health.”

The Department of Health has pushed back on media accounts, first appearing in The Palm Beach Post, based on an April report from the Centers for Disease Control and Prevention. That report said that the outbreak, which was first detected in 1999 and seemed to be clustered in a homess shelter, a jail and an outpatient mental health clinic in downtown Jacksonville, was the largest flare-up the CDC had been involved with since the 1990s. DOH says the stories exaggerate the dangers the outbreak, which affected about 99 people. A.G. Holley State Hopsital, which dealth with TB cases, closed at the beginning of this month.–News Service of Florida

Florida Surgeon General John Armstrong Calls Palm Beach Post Article Reckless

A war of words has erupted between one of the state’s major newspapers and Dr. John H. Armstrong, who is both Florida’s Surgeon General and secretary of the Department of Health.

In a statement sent to the media via e-mail Wednesday afternoon, Armstrong called an article about an outbreak of tuberculosis that appeared in the Palm Beach Post this week inaccurate, misleading and “reckless.” The headline on the article by Post reporter Stacey Singer was “Worst TB outbreak in 20 years kept secret.”

“I am disappointed that after a personal and in-depth discussion with Ms. Singer …., the Palm Beach Post made a reckless choice to misinform you by reporting on a cluster of TB patients that posed no public health risk and positioning this as a secret,” Armstrong wrote.

Armstrong said state DOH officials and Duval County Health Department worked openly on the matter, calling in a team from the Centers for Disease Control (CDC) and keeping community leaders informed.

He said state and local health officials followed CDC protocols all the way and were motivated by nothing other than public safety.

The Post article had suggested DOH downplayed the outbreak to preserve the governor and legislative leaders’ political agenda: shrinking the agency and closing AG Holley, the longtime TB hospital in Lantana.

Armstrong took particular exception to the article’s suggestion that the infection may have spread beyond Duval County and that the general population is at risk. He explained that TB is not usually transmitted through brief contact and that most of those exposed do not develop active infection.

“The people of Florida weren’t provided accurate medical details on TB to properly understand their risk and as medical experts, we are the authority in this matter,” Armstrong wrote.

Some questions that Health News Florida has sent to DOH this week about the TB outbreak were not addressed in his statement or by anyone else at DOH.

They include: How many of the 3,000-plus individuals who were identified as having had contact with those infected have been found and screened? As of the date of the CDC report, fewer than 10 percent had been evaluated.

Also: Where are the patients who are contagious being housed and treated? Singer’s article said some of those who were taken from Holley when it closed were sent to Jacksonville and housed in motels. Armstrong said in his statement that that was not true, but he didn’t say where they were.

Singer’s article was based in part on a letter and 25-page report by a CDC official who called the multi-year outbreak the worst he’d seen in a 20-year career in TB epidemiology. Since the cluster’s particular strain of TB was identified in a homeless schizophrenia patient in 2008, the report said, it was implicated in 99 illnesses and 13 deaths.

Meanwhile, a report in the Columbia Journalism Review headlined “The Palm Beach Post exposes a hidden menace” applauded Singer’s “old-fashioned muckraking journalism.”

Before Armstrong issued his statement but after a deputy secretary had issued one with similar sentiments, the Post published an editorial accusing DOH of recklessly covering up the outbreak in order to justify the closing of the TB sanitarium.

It called on Gov. Rick Scott to appoint a task force to investigate the handling of the TB outbreak and urged lawmakers to “realize that they made a mistake in closing A.G. Holley, and need a real plan for handling the state’s hardest-to-treat tuberculosis cases.”

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