State health officials propose six-bed TB isolation ward at Springfield Hospital

January 26, 1994|By Jackie Powder | Jackie Powder,Staff Writer

In an attempt to keep Maryland's tuberculosis rate under control, state health officials want to open a six-bed isolation unit for contagious TB patients in a vacant building at Springfield Hospital Center in Sykesville.

Dr. Ebenezer Israel, director of epidemiology and disease control for the state Department of Health and Mental Hygiene, stressed that the unit is mainly a preventive measure. He said he doesn't believe TB cases are on the rise in the state.

"We do not look at Maryland as having an outbreak. We're putting things in place and are trying to develop a strong tuberculosis control program so we don't wake up and find ourselves in a bad situation," Dr. Israel said. "We want to make sure we don't need 60 beds down the line."

In Maryland, there were 451 cases of tuberculosis in 1991 and 442 in 1992. Dr. Israel said 1993 figures will not be available until March, although he said he's reasonably certain the total won't exceed last year's count.

The $199,000 isolation unit is included in the state's proposed capital budget for fiscal 1995. If the project is approved by the General Assembly, he said, a fall opening is possible.

The unit would be housed in the Warfield E building at Springfield Hospital Center, a state hospital for the mentally ill. Renovations would include the creation of six bedrooms with private bathrooms, a nurses station, an air supply and exhaust system, and an ultraviolet germicidal lighting system to kill TB bacteria.

Dr. Israel said state health officials see a need for a facility in the Baltimore-Washington metropolitan area to care for contagious TB patients. Currently, the Deer's Head Center in Salisbury is the only state hospital equipped to admit TB patients who are contagious, he said.

But the Deer's Head three-bed TB unit is limited to patients who require the highest level of care, he said.

TB is a disease of the lungs that is spread through the air, usually when an infected person coughs or sneezes. It can also affect other partsof the body, such as the brain, kidneys or spine.

The proposed isolation unit would probably serve TB patients discharged from hospitals who have no place to go or who can't care for themselves at home. Dr. Israel said this population may include drug-addicted patients, the homeless and the elderly.

Other target groups are individuals with drug-resistant TB strains zTC that are difficult to treat, and TB patients infected with the human immunodeficiency virus, which causes AIDS, he said.

"We need a place for these people but they don't need to be in a hospital, which charges $600 to $700 a day," Dr. Israel said.

The drug-resistant form of TB usually develops when patients stop taking their medication before completing the standard six-month treatment.

In these cases, the most effective treatment is to have patients take prescribed drugs every day for one to two years to fight the disease, Dr. Israel said.

"It would be nice to have a place where they could be watched so they're not spreading the germs on the street," he said.

The nation saw a resurgence of TB in the mid-1980s after years of decline. The vulnerability of AIDS patients to the disease and dwindling resources to treat it were the main factors contributing to its increase, Dr. Israel said.

Maryland health officials have taken steps to ensure that TB doesn't become a public health crisis here as it has in other large metropolitan areas, such as New York and Miami, he said.

Last year, health officials were given more authority to quarantine patients who refuse to take their medication. However, Dr. Israel predicts that most of the patients would be admitted to the proposed isolation unit voluntarily.

State regulations went into effect in July requiring doctors to offer TB skin-testing to all patients who carry the AIDS virus. These patients are particularly vulnerable to TB because of their weakened immune systems.

Dr. Israel credits Maryland's success in controlling the spread of tuberculosis to an aggressive TB control program, which has gained national recognition. Public health nurses deliver medication to patients at their homes and watch the patients swallow the pills to make sure they take their medication for the entire treatment period.

The program, which has an 85 percent completion rate, recently received additional federal money that will allow for expansion, Dr. Israel said.

If the TB isolation unit is approved by the General Assembly, it will share space in Springfield's Warfield E building with a residential addictions-treatment center.

Shoemaker House, Carroll County's 17-bed treatment program in Westminster for alcohol and drug addictions, plans to move to Warfield E by April 1, said Larry L. Leitch, Carroll's deputy health officer.

Health officials say that putting the TB unit at Springfield in the same building with the addictions-treatment program would establish a "continuum of care," because it is likely that some of the TB patients will also need treatment for drug addiction.

Dr. Israel said the isolation unit includes features to prevent the infection of others in the building.

The unit and the rest of the building will have separate air-management systems, he said.

"It's a state-of-the-art isolation facility we're trying to build," he said. "We feel very confident it will be a safe unit."

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