By Peter H. Milliken
Voters in Mahoning County will find tuberculosis and children services levies on the Nov. 6 ballot, both being proposed five-year, countywide renewals of real estate taxes.
The 0.1-mill tuberculosis prevention and control levy, first enacted in 1976, funds a TB clinic at 496 Glenwood Ave. on the South Side.
Despite statistics showing a decline in TB incidence in the United States, the county’s voters are being asked to renew through the levy a tiny local investment in an important and effective testing and treatment program, county health officials said.
“Those statistics are the direct result of clinics like the TB clinic. This reduction doesn’t happen by accident,” said Dr. John S. Venglarcik III, county health department and TB clinic medical director.
“The reason why these go down is because of continued vigilance on the part of public health to ascertain the cases and adequately treat them, isolate [those who are ill] as appropriate, and then prevent dissemination to the rest of the population,” he added.
The United States had 10,528 reported TB cases in 2011 for a decline of 5.8 percent from 2010, the U.S. Centers for Disease Control and Prevention reported. The U.S. rate last year was 3.4 cases per 100,000 people.
“The average individual who’s diagnosed with tuberculosis has infected 71/2 people by the time they’re diagnosed,” Dr. Venglarcik said.
“Although our efforts are working, and it is declining, we haven’t eradicated it, and those cases that do exist still pose a severe threat to the community,” he said.
“More human beings have died from tuberculosis than all other infectious causes of death put together,” Dr. Venglarcik said.
The TB levy, appearing as Issue 4, raises about $176,540 a year and costs the owner of a $100,000 home $1.20 annually.
The clinic is staffed by a full-time registrar and a part-time nurse, with Dr. Venglarcik visiting weekly. All tests and treatments offered by the clinic are free to its patients.
“One Starbucks [coffee] will pay for two years,” said Diana Colaianni, nursing director at the county health department, which operates the clinic under a contract with the county commissioners.
Mahoning County did 2,262 tuberculosis screenings last year, including on-campus screenings of Youngstown State University students, with an emphasis on outreach to international students, who come from areas where TB is more prevalent than in the United States, she said.
TB clinic staff coordinate their efforts with the HIV clinic at Oakhill Renaissance Place, where Dr. Venglarcik is also the medical director, and with local jail and prison officials.
The HIV-positive population is especially at risk of developing TB because HIV- positive people have compromised immune systems; incarcerated people are at risk because they live in close quarters, which are conducive to the spread of the disease, Dr. Venglarcik said.
The county had 13 cases of the disease last year, of which 12 were latent (inactive) and one was active. In 2010, the county had 48 cases, of which 44 were latent and four active.
“The key is not how many cases of TB we had. It’s: How many cases of TB did we prevent?,” Dr. Venglarcik said. “When public health does its job perfectly, it’s invisible,” he added.
Every asymptomatic TB carrier who is diagnosed and treated with antibiotics saves many people from suffering considerable hardship, Dr. Venglarcik said.
One of the worst public health nightmares would occur if someone with active TB boarded a commercial airliner, potentially exposing to the disease hundreds of people breathing the same recirculated air on board, with all passengers having to be tracked and tested worldwide thereafter by public health officials, Dr. Venglarcik said.
One-third of the world’s population is infected with TB, which is the leading killer of HIV-infected people, according to CDC. Last year, nearly 9 million people got sick with TB, and about 1.5 million died of it worldwide, CDC said.
The voters also will consider a 0.5-mill Children Services Board levy, which generates about $1.3 million a year for general operating expenses of the child welfare agency and the care and placement of children.
The CSB levy, first passed in 1982, provides about 10 percent of the board’s annual revenue, said Denise Stewart, executive director. It will appear as Issue 5.
That levy costs the owner of a $100,000 home about $9.08 a year.
Funded by a variety of federal, state and local sources, CSB investigates child abuse and neglect and offers parent education, foster family care, emergency shelter, group home residences and adoption services.