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In early February, Duval County Health Department officials were so worried about the surge in the number of cases that they asked the U.S. Centers for Disease Control and Prevention (CDC) to become involved. The health officials felt that if they informed the public, the public would avoid the homeless. “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. The health agency recommended that the A.G. Holley State Hospital in Lantana, where tough TB cases were treated, be closed six months ahead of scheduled.On March 27, Governor Rick Scott, unaware that there was an outbreak, but aware of the health department’s recommendation, signed a bill that shrank the Department of Health and closed A.G. Holley.But on April 5, the CDC warned Florida health officials that the Jacksonville outbreak was rapidly gaining ground: 13 deaths and 99 illnesses, including six children, had resulted already. Three thousand people in the past two years may have come into contact with TB contagious people at Jacksonville’s homeless shelters, an outpatient mental health clinic and area jails. But only 253 people had been found and evaluated for TB.The public did not know about the outbreak until early June. Duval County Health Director Dr. Bob Harmon said, “There have been TB outbreaks where we do alert the public, such as a school or a college.”... The outbreak apparently started in 2008 when a schizophrenic patient went from hospital to jail to homeless shelter to assisted living facility. The patient’s cough was frequently documented in his chart, but not treated.“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.”
The CDC threw the matter back to the state. When asked to make an expert available to explain how the outbreak started, Salina Cranor of the CDC’s TB prevention office said, “After checking in with the Division of TB Elimination about your specific questions, they have suggested that you reach out to your health department. They are really the best source for your questions.”
It's not just homeless, a significant number of immigrants test positive for prior exposure to TB. From some areas, it's actually the majority.
