JACKSONVILLE, Fla. - As state officials moved to close a South Florida hospital specializing in tuberculosis treatment, federal health officials were finding a serious outbreak of the disease among the homeless in the northeastern part of the state, a newspaper reported Sunday.
An April 5 report sent to Florida health officials by Dr. Robert Luo of the U.S. Centers for Disease Control and Prevention warned Florida health officials that a tuberculosis outbreak in Jacksonville was linked to 13 deaths and 99 illnesses, according to a report by The Palm Beach Post.
"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 wrote.
His report warned that 3,000 people in the last two years may have had close contact with contagious people at Jacksonville's homeless shelters, an outpatient mental health clinic and area jails. However, only 253 people had been located and screened for tuberculosis, and a third of them tested positive for tuberculosis exposure, Luo wrote.
The newspaper obtained a copy of the report through a public records request.
In late March, Gov. Rick Scott signed a bill that consolidated the state's Department of Health and required the closure of the A.G. Holley State Hospital in Lantana, where tuberculosis cases had been treated for more than 60 years.
The health agency ordered for the Palm Beach County hospital to be closed six months ahead of schedule. The hospital, which closed July 2, was one of four tuberculosis hospitals left in the country and the only one in Florida.
Overall, the numbers of tuberculosis cases in Florida had declined statewide, officials said.
"Florida experienced a 10 percent decrease in cases for 2011 compared to 2010. For the period 2007 to 2011, there was a 24 percent decrease in cases," said Department of Health spokeswoman Jessica Hammonds.
State Rep. Matt Hudson, R-Naples, who had championed the health agency consolidation, said he did not know about the Jacksonville outbreak or the CDC report until Friday.
Hudson, chairman of the House Health Care Appropriations Committee, said tuberculosis treatment would continue to receive funding.
"There is every bit of understanding that we cannot not take care of people who have a difficult case of TB," Hudson said.
The governor's office requested a copy of the CDC report from the newspaper Saturday but did not respond to its request for comment.
Last year, Duval County sent 11 patients to the A.G. Holley State Hospital under court order. In February, the county's health department requested help from the CDC when the number of tuberculosis cases spiked.
Believing the outbreak was contained within the homeless population, Duval County health officials decided not to inform the general population. It was the same decision county officials made in 2008, when the same strain appeared in an assisted living home for people with schizophrenia.
"What you don't want is for anyone to have another reason why people should turn their backs on the homeless," said Charles Griggs, the public information officer for the Duval County Health Department.
It was not clear whether the outbreak had spread beyond areas where the homeless congregated in Jacksonville.
Florida's surgeon general and the CDC's tuberculosis prevention office referred the newspaper's questions about the outbreak back to the county.
"With TB it's a judgment call," Duval County Health Director Dr. Bob Harmon said Friday.
The CDC sent a $275,000 grant to help contain the 2008 outbreak.
"We thought after 2008 that we had it contained," Harmon said. "It was not contained. In retrospect, it would have been better to inform the general population then.
Harmon said the Duval County Health Department will need more resources to contain the current outbreak. In 2008, his department employed 946 staff with revenues of $61 million.
"Now we're down to 700 staff and revenue is down to $46 million," Harmon said.
County officials told the newspaper that only a few cases of the current outbreak have developed drug resistance.
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