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    Drug-Resistant TB Continues in California

    Experts Say Tuberculosis Continues to Be a Global Problem

    Efforts Failing continued...

    Patients with drug-resistant tuberculosis are four times more likely to die than patients with standard tuberculosis. Forty-nine of the California patients, or 14%, died from their drug-resistant infections, according to the study, published in the Tuesday issue of The Journal of the American Medical Association.

    A total of 233 Americans died in 2003 from all forms of tuberculosis. That pales in comparison to death rates in developing nations, where tuberculosis often infects up to one-third of the population, according to the CDC.

    Tuberculosis Not Just in Cities

    Epidemiologists have long observed that tuberculosis tends to concentrate in urban centers. But researchers were alarmed by findings showing reports of multidrug-resistant tuberculosis in more than half of California's health jurisdictions, including several rural counties.

    "Multidrug-resistant TB has spread across the state," Granich says.

    Researchers call for stronger efforts aimed at identifying and treating tuberculosis overseas, noting that the majority of infected persons in the California study were from foreign countries. They also note that one-third of multidrug-resistant tuberculosis patients in California did not complete their treatment and that officials must step up efforts to improve complete treatment of the disease.

    Catherine D. DeAngelis, MD, editor of JAMA, told reporters that relatively low domestic tuberculosis rates have convinced much of the public that the disease is no longer a threat in the U.S. But worldwide tuberculosis infection rates are 33 times higher than those for HIV.

    "Don't get too comfortable. It is a global problem," she says.

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