AUDIE CORNISH, HOST:
Texas has one of the highest rates of tuberculosis in the U.S. Now a sweeping effort is underway to diagnose and treat people who don't know they harbor the lung infection. Wendy Rigby of Texas Public Radio reports on how one part of the state is tackling the fight.
WENDY RIGBY, BYLINE: At San Antonio's largest homeless shelter, huge fans cool off the temporary residents. The courtyard can get crowded. One of the hundreds of nightly boarders is 55-year-old James Harrison.
JAMES HARRISON: I lost my apartment and had nowhere else to go. That was four months ago.
RIGBY: Like most people at Haven for Hope, Harrison doesn't plan on staying long. But while he's here, he's taking advantage of some free medical testing - a screening for dormant tuberculosis.
HARRISON: People don't even think about TB anymore because you don't see - you don't see it out there. You know, and there's nothing that tells you until it's too late that it's there.
UNIDENTIFIED WOMAN: Doing OK, sir?
UNIDENTIFIED WOMAN: Great.
RIGBY: One vial of blood can be tested to see if people are carrying TB without showing symptoms. That's called latent tuberculosis infection, a condition that puts them at much greater risk of developing the coughing and mucus production of the full-blown disease, says Dr. Barbara Taylor.
BARBARA TAYLOR: It goes into your lungs, and usually it hides there dormant for years and years. Although it sounds very scary, it is completely treatable.
RIGBY: Taylor is an infectious disease specialist who is part of a program called BEST, Breathe Easy South Texas, an ambitious $2 million effort. The state and local health departments are teaming up with a medical school and a health system to screen at-risk people in 20 counties, an area larger than some entire states. They offer testing at places like shelters, diabetes clinics, low-income medical offices.
TOMMY CAMDEN: It's not a problem that's on the south side or east side. It's a problem all across Bexar County.
RIGBY: Tommy Camden of the San Antonio Metropolitan Health District emphasizes TB rears its ugly head in urban and rural communities.
CAMDEN: It doesn't care what color you are, how much money you make. As long as you're breathing, you're susceptible to catching tuberculosis.
RIGBY: Still, some populations are at greater risk of carrying TB - the homeless, diabetics, drug abusers and people born in other countries. For most people who test positive, the diagnosis of latent TB comes as a surprise, says Camden.
CAMDEN: We've got some huge challenges ahead of us.
RIGBY: Because they know there are so many cases of latent TB out there. Camden says besides Texas, California, Florida and New York have the highest rates of TB. He hopes those states can mimic the BEST program, which has screened 3,500 people a year. Nine to 10 percent had latent TB. Nurse Diana Cavazos with University Health System is part of the testing team.
DIANA CAVAZOS: I am passionate about this because this condition can affect you when you least expect it.
RIGBY: She says those who test positive are given X-rays and a 12-week course of antibiotics, even transportation to the appointments if they need it, all free.
CAVAZOS: Testing, supplies, treatment, X-rays - it's completely covered.
RIGBY: Paid for by Medicaid. But future funding is a question mark. The talk in Washington of Medicaid cuts is creating uncertainty at precisely the time the TB testing program has plans to expand. For NPR News, I'm Wendy Rigby in San Antonio.
CORNISH: And this story is part of a reporting partnership with NPR, Texas Public Radio and Kaiser Health News.
(SOUNDBITE OF LOCAL NATIVES SONG, "WIDE EYES")
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