Tyler

By COSHANDRA DILLARD
Staff Writer

Physicians, medical researchers and technicians at the University of Texas Health Science Center at Tyler on Tuesday will gather to reflect on 15 years of advancements in the study of pulmonary diseases.

The Center for Pulmonary and Infectious Disease Control is an extension of the hospital's 54-year history in the diagnosis and treatment of diseases of the respiratory tract, including tuberculosis, a lung disease caused by bacteria.

The center began on UTHSCT's campus in 1993 when the 73rd Texas Legislature allotted $1 million for the center to conduct research of infectious lung diseases following an increase of tuberculosis over a seven-year period.

While the occurrence of tuberculosis has decreased in the country since then, Dr. Peter Barnes, director of the CPIDC, said the center still offers a valuable service to not just East Texas, but the state.

The center's operation is similar to the Center for Disease Control and Prevention in Atlanta but on a much smaller scale.

CPIDC director Dr. Peter Barnes, who has been at the center for 11 years, said the primary functions of the center are to provide consultations to physicians and state health workers, education and continue biomedical research.

He said physicians in large metropolitan areas such as Dallas and Houston, as well as rural areas have called the center's hotline for assistance.

The founding of the center was groundbreaking in that it is one of a few in the country, Dr. Barnes said.

"At the time (1993), TB was thought to be on the rise and there needed to be a center that focused on that," he said. "It's still important in terms of telephone consultation. Cases of TB have declined because they have put a lot of money into the public health districts."

Dr. Barnes was involved in developing a more accurate blood test for tuberculosis, which he says is a more efficient and objective method in getting a diagnosis. The traditional skin test, which has to be "read" two or three days after the test, is not always accurate, he says, and depends on the patient returning to receive those results by a health professional.

The blood test has been available for about three years and the improved test was introduced last year. Dr. Barnes said it is currently being used at UTHSCT and he hopes it will one day replace the TB skin test.

According to CPIDC reports, more than 15,000 people are diagnosed with tuberculosis each year, with 1,700 of those cases in Texas.

Dr. Barnes said although there has been a decrease the U.S. in the last few years, tuberculosis cases are steadily rising in other countries.

According to CDC data, the tuberculosis incidence rate in 2007 was the lowest recorded since national reporting began in 1953, although the rate in foreign-born persons in the U.S was 9.7 percent higher than U.S. born persons.

In addition, 3-4 percent of cases in the country are drug-resistant, compared to 20 percent along the Mexico border, Dr. Barnes said.

He said a primary reason for the problem is because poorer countries cannot handle the expense and time it takes to treat tuberculosis. He also noted the correlation between TB and HIV.

"Worldwide, TB is the number one killer of HIV. HIV destroys part of the immune system based on T cells which protects against TB," he said.

The CPIDC has a team of 20, which includes Dr. Barnes, five faculty members and 14 research associates. Dr. Barnes said researchers are in phase one of a vaccine, which will not be tested for another 10-12 years.

"We are proud that we are able to be of help around the state," he said. "We are a small institution, but one of the top five institutions in the area of TB research. There are eight TB researchers here outside of center. There aren't very many facilities that have more than one person studying tuberculosis. It's unique in Texas and unique in the U.S. That, we are very proud of."

TB MYTHS AND FACTS

Only poor people get TB

-- Dr. Barnes said while there are risk groups for TB such as people with AIDS and people living in crowded areas, tuberculosis can happen to anyone.

"A lot of people don't understand how it is transmitted," he said. "It's not because you are poor or aren't clean. It travels through the air. It is easier to get infected than most people think. Anyone who breathes can contract it."

Smoking causes TB

-- While it hasn't been explained yet, smokers are at a greater risk for getting TB.

"Smokers are three to four times more likely to get TB than non-smokers. We have a small grant right now to help us find out why that is."

I tested positive for TB but my chest x-rays are clear, so I don't need antibiotics

-- This in not necessarily true, Dr. Barnes said.

"Generally, if you have a positive skin test and normal x-ray it means you have TB bugs that are not active. It could cause problems in the future if you develop cancer, are taking drugs, getting older...you are at risk for getting TB. Most would benefit from the treatment."

Dr. Barnes said a patient with inactive TB would receive one treatment over a nine-month period, while a patient with active TB receives three to four treatments over about six months.

TB Timeline

400 BCE -- TB was also known as consumption. The Greek word for consumption, phthisis, was created by Hippocrates, which means to waste away.

1546 -- The book

De Morbis Contagiosis

was written by Girolamo Tracastoro. He explained that bed sheets and clothing could contain contagious particles.

1882 -- Robert Koch develops a staining technique to view the disease. Sanatoriums were being widely used, isolating those infected with TB from the healthy population.

1890 -- The first therapy, collapsing the lung, was created by an Italian doctor.

1943 -- The first antibiotic, streptomycin, is developed.

1970 -- First outbreak of drug-resistant TB occurs in the U.S.

1993 -- World Health Organization declares TB a global emergency

2008 -- Biomedical researchers continue study of vaccines. Expects a TB vaccine regimen around 2020.