Tuberculosis cases in California declined for the seventh consecutive year, according to statistics released this week by state health officials.

But that's not the situation in the Northern San Joaquin Valley.

While the number of new, active tuberculosis cases dropped more than 6 percent statewide, Stanislaus, San Joaquin and Merced counties each saw increases.

In 1999, Stanislaus County counted 34 new tuberculosis cases compared with 25 the previous year. San Joaquin County logged 74 cases in 1999 and 65 in 1998. Merced County had 11 cases last year, up from eight two years ago.

Tuolumne County was the only area county where tuberculosis cases decreased, dropping from eight cases in 1998 to none last year.

Local health officials said valley communities are home to many people who are at higher risk for developing tuberculosis: migrant workers and the elderly.

"We have a high migrant population with people coming and going and they bring (tuberculosis) with them," said Merry Baker, a public health nurse for the Stanislaus County Health Services Agency.

Poor nutrition and existing medical problems that go untreated compound the problem, Baker added.

Tuberculosis is a contagious disease transmitted through the air when someone with active TB coughs or talks. Active tuberculosis can take anywhere from six months to two years to cure.

State and federal health officials estimate 10 percent of Californians are infected with the bacteria but only a small number develop active TB.

Kathleen Tully, who manages San Joaquin County's tuberculosis control program, said until last year, San Joaquin had been experiencing a decline in new TB cases.

"We had been in the 100s, anywhere from 98 to 120 cases, until mid-1990s then we dropped down to the 60s range," Tully said. "We stayed there for three or four years. This past year we had an increase. and we've been analyzing why that may be happening."

The nation saw a marked increase in tuberculosis in the mid-1980s as a result of AIDS, overcrowding and unsanitary conditions in cities, homeless shelters and prisons. Health officials also saw an increase in some strains of tuberculosis that were resistant to the antibiotics.

Increased funding from state and federal governments helped bolster county health departments' tuberculosis detection and treatment efforts.

"We review a lot of lab information and that helps us identify more cases," Tully said.

That increased funding has helped county public health departments establish more aggressive treatment programs. Stanislaus, San Joaquin and Merced counties all have observed therapy programs where health workers watch as TB patients take their medications.

"One of the keys in curing and developing resistance is to make sure people take their medications daily and that they are taking the right dosage," Tully said.

The California Department of Health Services released its findings this week to coincide with World Tuberculosis Day, which is Friday. Health workers across the nation observe the day in hopes that tuberculosis will be eliminated.

Reprinted by permission of Modesto Bee.