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.
Since taking office, Florida Gov. Rick Scott (R) has slashed health and human-services agencies while offsetting costs with corporate tax cuts. During last year’s legislative session, the Florida Department of Health took a total budget reduction of $55.6 million, eliminating hundreds of full-time positions and cutting children’s medical services.
Officials cut almost $4 million from Florida’s infectious disease control budget and the A.G. Holley State Hospital — where tough TB cases had historically been treated — was closed. The Florida Department of Health has released figures alleging that statewide TB figures are on the decline. The CDC’s report, however, suggests the strain has moved beyond Jacksonville’s homeless shelters, spreading across the entire state and reaching the general population.
One-third of contacts reached for the CDC’s report tested positive for TB exposure in areas like homeless shelters. Treatment for TB, especially among the homeless population where the disease often germinates, is costly and complicated. Patients must take a cocktail of several drugs for 6 to 9 months, and failure to adhere leads to a drug resistance that makes the disease increasingly difficult to treat.