to the editor: Regarding the article on treatment of tuberculosis by Drs. Inge and Wilson, we would like to emphasize the importance of family physicians collaborating with the local health department for a number of reasons:
suspected active tuberculosis is a reportable disease in most U.S. jurisdictions;
management of active tuberculosis cases is often neither simple nor straightforward;
most family physicians in the United States encounter tuberculosis relatively infrequently, whereas local or state health departments often employ highly experienced experts in tuberculosis management and follow-up of high-risk patients;
local health departments have the resources to thoroughly investigate all potential at-risk contacts to a case of tuberculosis, and to make recommendations about monitoring and/or providing preventive therapy for at-risk contacts;
health departments may assist with outreach education of health care personnel;
unlike family physicians’ offices, health departments frequently have staff dedicated to providing directly observed therapy for both latent and active cases of tuberculosis; and
upon request, local health department staff will help manage cases of tuberculosis in close collaboration with the family’s physician.
For tuberculosis and many other communicable diseases, the local health department is a valuable and often underused resource for family physicians.