A small town with a big problem: Tuberculosis in Marion

Jan 18, 2016

West Central Alabama is dealing with an outbreak of Tuberculosis.  APR’s MacKenzie Bates went to the city of Marion to find out what officials are doing to contain the respiratory disease…

The community of Marion is tucked in to Perry County. It might seem like a quaint town--very rural, not a lot of traffic lights and a small population.  Less than 36-hundred people live here, to be exact.            If anything happens in Marion, no matter how big or small, the folks hear about it. That includes Tuberculosis

“In the state of Alabama the case rate is 2.8. It’s 253 here in the town of Marion.”

That’s Pam Barrett.  She’s the director of the division of TB control for the Alabama Department of Public Health.  The rates in Marion alone are 100 times greater than the state average, and worse than many developing countries like Kenya, Bangladesh and China.

“I would say that there are probably not very many towns at all in the United States that have a case rate that high,” Barrett says. 

“Why do you think it’s so high?” 

“Because of the number of cases that have not shared their contacts and people have not come forward to be screened and be treated preventively.”

That’s despite the fact that Tuberculosis can be fatal. Since January of 2014, 20 people have tested positive for “Active TB” in Marion alone and six more in the surrounding counties.  Three of those patients have died. Since persuasion wasn’t working, health officials resorted to Plan-B. B as in bribery. The state is offering $20 to anyone in Marion to get tested at the Health Department.

“When they sent the flyer out paying people to come and be tested, I’m thinking we’ve got something bad going on here.”

That’s Bennie Royster.  She attended a town hall meeting last week along with about 50 other residents at Francis Marion High School’s auditorium.  She hasn’t been tested for TB but she wanted to come to the meeting for a better understanding of the disease.

“Listening at them tonight, I’m less afraid,” Royster says.  “And if I were to come down with TB, because I asked this question about the privacy act like they said because we’ve had so many people that have already died in Perry County, I wish I knew the person.  Because if I knew the person, then I know to go and be tested.”

Fellow Marion resident Cynthia Bagley…says she took her and her family to get tested for TB at the Perry County Health Department not to just grab a quick buck but to be on the safe side.

“I got there a little after one and I stayed until 25 after three,” Bagley says.  “I was the last one.”

“I wanted to make sure my grandkids are also tested because with me just getting tested we still wouldn’t know.  With my grandkids in the family, they’re around me so I don’t feel like it would be right for me to be tested and my grandkids not get tested.”

The results are still coming in but just short of 800 people have come in to the Health Department in a week to be tested.  Of those tested, they have identified 37 people infected with the TB bacteria, but they’re not infectious.  More results are expected to be released in the coming days.

That’s about $16,000 in a week of testing and it’s expected to climb this week as more people come in to get tested.  Pam Barrett says the money handed out to people for the tests are provided by grants from the Center for Disease and Control and Prevention.  People can also earn more money with follow-up visits, getting a chest x-ray and anyone infected who completes treatment.

Bennie Royster saw the long lines at the Health Department and was concerned she might not be able to find time to get her and her family tested.

“The first day, there were so many people at the health department it scared me,” Royster says.  “So I got all of my grandbabies and I called my primary doctor in Hale County and see if I could bring them over to be tested and they told me it was going to stay contained to Marion.”

Barrett says the Health Department is still looking for the cause of the outbreak.

“We believe there are possibly two or three that could have been the initial cases that kind of started that,” Barrett says.  “But because of the lack of them giving contact information in people that they have been around, that just made it more difficult for us.”

So Barrett and the rest of the Alabama Department of Public Health are relying on its citizens to get the word out about being tested. Cynthia Bagley of Marion knows one of the three people who died.  She is doing her part to help eradicate the outbreak.

“I did encourage them to go get tested and they was also when I went do so hopefully everything with them will turn out okay,” Bagley says.

With appropriate antibiotic treatment, TB can be cured in most people. For active tuberculosis patients, it can take longer than six months. Preventive treatment for people who test positive for tuberculosis but don't show symptoms can take up to six months.