Tuberculosis is caused by bacteria that usually attack the lungs. Last year, there were 398 cases of tuberculosis reported in North Carolina. Forty-one cases were in Wake County, the most in the state. Nineteen cases were in Durham County and three cases were in Orange.
Most involve immigrants from places where tuberculosis is common such as Mexico, Central America and parts of Asia. Dr. Carol Dukes Hamilton, an infection disease expert at Duke who heads up the state's tuberculosis control program, said one of the biggest obstacles is getting people into clinics for treatment.
"Some of the problem is getting them into the system because they often don't have medical insurance. If they are undocumented, they use the emergency rooms," Hamilton said.
Tuberculosis has a 95 percent cure rate when treated correctly, but it is rigorous.
"This requires six months of treatment with pretty difficult-to-take medications," Hamilton said.
To make sure patients take the medicines properly, North Carolina takes a unique and aggressive approach. Medications are provided for free, but patients with active disease must come to the clinic to take their medicine. It is called directly observed therapy.
"It ensures that that person, in fact, takes every single one of the medicines," Hamilton said.
It also lets nurses monitor how patients are doing. Thanks to those type of programs, tuberculosis cases in the state are on the decline.
Nurses go into communities to educate people in high-risk populations. The program also provides medications for people who are infected with tuberculosis, but are not sick. That way, they do not develop symptoms.