Tuberculosis Q&A

Q. I have a question about Tuberculosis.
Last week in the news, I heard about the young attorney who was diagnosed with Tuberculosis prior to his flying off to Europe to be married. He apparently exposed many people to TB and it could have been me. What’s my risk and how would I know if I have been infected?

A. The gentleman you speak of was diagnosed with the most difficult kind of TB to treat, called Multiple Drug Resistant TB or MDR-TB and his actions subsequently put many other people at risk. This case points up the challenges we have in containing a disease which is worldwide.

While Tuberculosis is a disease many of your listeners will have heard about, it’s not a disease many of them have had experience with. In fact, until the past few years, it was on the decline in the United States. More recently, we are seeing a resurgence in TB cases, especially the MDR type.

Since we are a global economy, we are traveling to endemic destinations once considered remote. However for us, even greater sources of infection are people coming to the United States. For example, King County is currently witnessing an outbreak of active TB within a community of people from the Marshall Islands who reside here. Locally in King County, we normally see between 150-200 active cases each year. Worldwide though, 2 million people die each year due to TB, which is more than any other infectious disease.

TB is a bacterium which is passed via lung secretions. It can invade the body and lay dormant inside us for long periods of time and is not considered infectious to others in this state. However, this can go on to become “active” and contagious, so finding TB in it’s dormant phase and treating it before it become contagious is akin to putting a fire out while it’s still in the fire pit.

Q. How can I tell if I’ve been exposed to TB?
A simple, routine screening test at the time of a wellness exam, or any other time, is a great place to start. This test, called a Mantoux PPD test is like an allergy test. It’s administered on the forearm and evaluated two days later. If there is a bump at the site of injection, that could be considered a positive test. No bump is a negative test. In my practice, we routinely screen every 5 years, or sooner, if someone has been traveling to infectious areas of the world or if they have come in contact with someone with TB symptoms, such as a severe, productive cough which lingers for a long period of time.

A. Treatment for TB is not a one-size-fits-all scenario so suffice to say, the important thing is to simply get tested and see if you are at risk. Ask for it at the time of your next physical, whether it be at your general practitioner’s office or gynecologists office, since the gynecologist is often the only doctor a woman sees in a year’s time.

To your health!
Dr. Larry
www.cmadoc.com