THE PATIENT breaks out in a terrible sweat. There is a loss of appetite, a fever and a hacking, contagious cough. Those are symptoms of tuberculosis, a disease that, once it finds a home in the body, can remain dormant for years until old age or illness triggers a full attack. It has had a known and available remedy since the early 1950s and, shamefullly, it occurs here in Washington at four times the national rate. The District is among the top three cities in the nation in incidence of TB. Only cities experiencing an influx of Asian immigrants surpass this one.
Much of the blame lies with the city's Department of Human Resources. Since 1972, it has cut TB funds in half and reduced the TB staff by two-thirds to about 30 people. The laboratory that tests its TB samples has produced unreliable results for years, doctors say. For the last three years, the city's TB program has had no director.
According to both Dr. Alfred Munzer of the D.C. Lung Association and a DHR report, adding $300,000 to the city's $600,000 TB program would ensure a full assault. But Dr. Arthur Hoyt, the mayor's special health assistant, says the city lacks the money and will just have to make better use of the resources at hand. Meanwhile, he says, a director has been named and money found to pay six people to begin searching out TB cases next October. Nothing more can be done until the reorganization of DHR is finished next summer.
A more efficient DHR is indeed the ultimate solution. But it is wrong to allow TB -- or, for that matter, veneral disease and infant mortality, the city's two other major health problems -- to be given only passing attention until DHR's larger troubles are treated. A special, concentrated one-year TB program should be instituted outside DHR to find people who have come in contact with known cases and to upgrade the city's TB laboratory. This is urgent.
In recent years the city's response to health problems like TB has bordered on negligence. It should not be tolerated for another minute, and certainly not for another year, even with the promise of a better DHR.