In Dallas County, there's a disease so dreaded that people diagnosed with it must agree to take medication for six months and allow a government worker to watch them swallow the pills every day.
The number of TB cases in the county fell below 200 for the first time last year. It is so serious that the medication is hand-delivered wherever an infected person can be found, even if it's in a cardboard box under a downtown bridge.
"We can meet them at a McDonald's or a 7-Eleven or a gas station," said Tesfa Kidane of Dallas County Health and Human Services.
He oversees the 10 outreach workers who religiously keep track of and treat Dallas County's nearly 200 tuberculosis patients – an approach so successful that TB cases dropped 11 percent in 2009 from the previous year.
Why such a hard-nosed approach for a disease that has nearly been stamped out in the U.S. and is highly treatable?
"This disease, if left untreated and unchecked, could decimate a community," said Dr. Garry Woo, medical director of tuberculosis control for Dallas County.
And if patients refuse to take their meds or miss too many of these rendezvous, county health officials will have them quarantined.