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Written by Lourdes Pichs Rodríguez

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The silence of the international media about the worst outbreak of an epidemic of tuberculosis (TB) in Florida, United States, in the last 20 years attracts the attention, but even more that the governor of that south state of the U.S., Rick Scott, disregards the complex health problem.

Both the silence of the big media as the negligent attitude of the Florida Governor, are of great concern because to prevent and control TB, one of the three most important transmissible diseases in the world these days, it is imperative to keep the population informed, provide medical care to patients and extreme sanitary measures.

It is no coincidence that the World Health Organization (WHO) considers prevention as one of the most important actions in its projects to stop TB. This infectious disease is one of the three major transmissibles at this time in the world, so the need for urgent actions in its control.

For example, in 2010, there were 8.8 million cases of tuberculosis, 1.1 million deaths among HIV patients and about 0.35 million additional deaths from TB associated with HIV.

In addition, 5.7 million new and recurring cases were reported, equivalent to 65 percent of the estimated number of patients in 2010. Between 1995 and 2010, 55 million TB patients were treated in health programs that had adopted the Stop TB project and 46 million were successfully assisted. These medical treatments saved nearly 7 million lives.

Since 1997, Cuba joined the National Program of Tuberculosis Control actions to eradicate the disease as a health problem. The rate in 2011 was 6.7 per 10 000 inhabitants, while the mortality rate has not suffered significant changes and has remained at rates of 1 per 10 000 inhabitants in recent years.

Since 2000, there is a history of TB rates below 7.0 per 10 000 inhabitants in the province of Holguin, near and even below the phase-out project. For example, in 2011the province achieved a rate of 4.3, the third lowest in the country.

The municipality with the highest incidence is Holguin, who is the only high-risk in territory. Other statistics show that males and adults over 60 years old are the most affected, while alcoholics, TB contacts and healthcare workers are among the most vulnerable.

The work being carried out in primary health care has allowed that more than 60 percent of cases are diagnosed by the doctor and nurse from the family's office and to reduce the number of patients with TB / HIV-AIDS, but due to its importance in the perpetuation of the disease worldwide, the Cuban health system continues monitoring the disease and improving adherence to antiretroviral chemoprophylaxis and medical treatment to this vulnerable group, say experts.

TB is transmitted by air, like the common cold, and has a high incidence worldwide. It may be noted that a third of the population is infected with Mycobacterium tuberculosis.

The infection is transmitted only by people suffering from pulmonary tuberculosis (PT) through cough, sneeze, talk, laugh, sing, or spit, as they expel the air the germs of the disease, known as bacilli. Just inhaling a small number of bacilli, a person can catch the infection, which if not treated early can cause death.

World researches show that a person with tuberculosis, without drug treatment, infects on average between 10 to 15 people a year. Every second is a new infection by the TB bacillus and it is estimated that 5 to 10 percent of those infected ( not suffering from HIV / AIDS) become sick or are affected at some point in their lives.

Every year 2 million people die in the world, which represent 25 percent of all avoidable adult deaths in developing countries. This means that TB remains a major health problem that extends to most nations.