How Health Officials Monitor TB after a Natural Disaster
This year’s Atlantic hurricane season was one of the most destructive on record in the United States, posing particular problems for local health departments in affected areas. Hurricane Harvey, which slammed Houston, Texas, with 45 inches of rain, and surrounding areas with 60 inches or more, provided the Texas Department of State Health Services (DSHS) an unwelcome opportunity to implement its preparedness plans to care for 282 people with tuberculosis (TB).
According to the U.S. Centers for Disease Control and Prevention (CDC), the Texas agency uses federal and state funding for TB surveillance, prevention, and control activities in eight regions, 31 local health departments, and four bi-national TB projects. In advance of major storms like Hurricane Harvey, TB programs activate protocols for providing patients with medications to take on their own and contact information to health departments in case patients become displaced. Patient listings are closely monitored through local, regional, and state-wide programs to ensure all are accounted for, and treatment duration may be extended, allowing for missed doses, in an emergency.
A cornerstone of TB control activity is directly observed therapy (DOT) of patients taking each dose of their TB medications. During an emergency, video-enabled DOT using electronic devices, such as smart phones, is a useful tool for patients who cannot visit, or be visited by, a health care provider. Through the efforts of local and regional health departments in the Houston area, 97 percent of patients with TB were monitored successfully and did not miss any medication doses, and no suspected cases of undiagnosed TB disease were identified in shelters.