March 24, 2004

Officials announced today that the Michigan Department of Community Health (MDCH) Bureau of Laboratories has received one of two coveted contracts with the Centers for Disease Control (CDC) to conduct strain typing on human Tuberculosis (TB) for half the United States (U.S.).

The five-year, $2.5 million contract will fund genotyping – a very specific form of DNA fingerprinting that improves disease investigation and tracking efforts – for the eastern half of the country.

Human TB, caused by bacteria that usually attack the lungs, can lead to weakness, fatigue, weight loss, fever, chills, severe chest pain and coughing. Genotyping can help trace where the disease originated. Identifying specific strains will help the CDC and other states confirm clustered/related cases or outbreaks of the disease.

“This partnership with the CDC puts Michigan at the forefront of TB outbreak identification and will help control the potential spread of the disease,” said MDCH Director Janet Olszewski.

Today, a DNA fingerprint from a laboratory confirmed case is obtained within 10 days following receipt in the MDCH laboratory. Previously, it took 4 to 8 weeks to obtain the DNA fingerprint of a culture confirmed case of TB. TB, which causes two million deaths worldwide, is the second leading cause of infectious disease death in adults.

In 2002, there were over 15,000 TB cases in the U.S. In Michigan, there were 243 active human TB cases last year.

“Tuberculosis is treatable with a nine-month course of antibiotics,” said Dr. Matthew Boulton, Chief Medical Executive for the state of Michigan. “It is extremely important that patients continue with treatment, as the most serious aspect of the disease is the recent occurrence of drug-resistant TB, which poses an urgent public health risk.”

Ethnic and racial disparities in those afflicted with TB are cause for concern both nationally and in Michigan. For example, African Americans make up only 14.2 percent of Michigan’s population, but represent over 41 percent of the active TB cases in the state.

“African Americans and foreign-born individuals in Michigan, who are afflicted by this disease in disproportionate numbers, must get the treatment they need,” Olszewski said. “This CDC funded genotyping will complement Michigan and U.S. efforts to combat TB.”

Foreign-born students, immigrants, visitors and temporary workers represented 42 percent of the TB cases in Michigan last year. In 1995 foreign-born cases represented only 12 percent of those with active TB disease in Michigan, Olszewski said.

“We need to address the fact that at no other time in Michigan’s history has the percentage rate of foreign-born TB cases been so high,” she said. Although TB screening is required for people immigrating to the U.S., there are no pre-entry requirements at this time for students and temporary visitors/workers.

Just 50 years ago TB was the leading cause of death in the industrialized world and in the late 19th century, the disease - then known as “consumption” - killed one out of every seven people living in the United States.

World TB day was established March 24, 1982, a century after Dr. Robert Koch announced the discovery of the TB bacillus. At the time, his discovery was the most important step taken towards the control and elimination of this deadly disease