Responding to media reports that he called “outrageous,” a top Florida health official late Monday said prudent steps have already been taken to contain what federal investigators have described as the largest outbreak of tuberculosis anywhere in the United States in the past 20 years.
Florida Department of Health officials said a spike in TB cases among homeless people in Jacksonville is being aggressively addressed and recent media reports that the outbreak has been kept secret are not justified. “After these inaccurate reports, it is important for the public to know, the number of TB cases in Florida has been trending downward for several years,” said Dr. Steven Harris, DOH deputy secretary for health. “The increase in this particular strain of non-drug resistant TB has affected approximately 99 people over the past eight years.”
Harris was responding to a news story first published in The Palm Beach Post and then picked up by other publications. The story related to an April report from the Centers for Disease Control and Prevention following a surge in cases of the highly contagious disease that appeared to be clustered in a homeless shelter, a jail and an outpatient mental health clinic in downtown Jacksonville.
“That report had been penned on April 5, exactly nine days after Florida Gov. Rick Scott signed the bill that shrank the Department of Health and required the closure of the A.G. Holley State Hospital in Lantana, where tough tuberculosis cases have been treated for more than 60 years,” the Post reported.
The CDC report raised alarm by noting that the outbreak, first detected in 2009, represented the largest such TB flare-up the CDC had been involved with since the 1990s.
“Dr. Robert Luo’s 25-page report describing Jacksonville’s outbreak — and the measures needed to contain it – went unseen by key decision makers around the state,” the Post continued. “At the health agency, an order went out that the TB hospital must be closed six months ahead of schedule. Had they seen the letter, decision makers would have learned that 3,000 people in the past two years may have had close contact with contagious people at Jacksonville’s homeless shelters, an outpatient mental health clinic and area jails. Yet only 253 people had been found and evaluated for TB infection, meaning Florida’s outbreak was, and is, far from contained. The public was not to learn anything until early June, even though the same strain was appearing in other parts of the state, including Miami.”
The report went on to say most of the potentially infected persons remain undetected and highly mobile, a combination that makes it more difficult to contain and treat the disease, which requires a relatively long and deliberate regiment of drugs and can become resistant. The report came as state health officials were in the process of closing down A.G. Holley State Hospital in Palm Beach County, the state’s last facility dedicated to tuberculosis treatment.
Lawmakers involved in the closure have said they had no knowledge of the CDC report. Slated for closure by the end of the year, state health officials accelerated the process and closed the facility six months early. “I think the two issues are separate,” said Sen. Joe Negron, R-Stuart, and chairman of a key Senate health care committee, who said he was unaware of the CDC report, which came out after lawmakers had already completed their work and gone home.
“The high number of deaths in this outbreak emphasizes the need for vigilant active case finding, improved education about TB, and ongoing screening at all sites with outbreak cases,” Luo’s report states.
Gov. Rick Scott is in England until Thursday.
Sunshine State News’ Nancy Smith is dubbing the story TBgate. “The Post reported that its repeated requests to see the CDC report fell on deaf ears until reporters showed up in person at the state Department of Health in Tallahassee,” Smith writes. “Why did it take months to get a report that should have been readily available under Florida’s Sunshine Laws?
When Smith posed questions to a Scott spokesman, he replied with a statement: “The term ‘large outbreak’ is grossly inaccurate. It was an isolated cluster on one particular strain of TB. There have been approximately 99 individuals diagnosed with that strain of TB over the last eight years. All of them were part of an isolated community and had … an isolated strain of TB (FL0046, to be specific). This strain is a non-drug resistant strain, meaning it is the easier type of TB to treat.”