with a rare form of tuberculosis sparked concern and legal action in Louisiana. Now approximately 200 students and staff members at a Georgia high school have undergone tuberculosis testing after a possible exposure on campus.
the article then quotes a local public health doc who says that TB is treatable, so hopefully it is not a case of drug resistant TB.
when I adopted my kids, my oldest had a chest x ray to check if he had TB to be cleared for a visa. The youngest was exempt, because his tb skin test was weakly positive because he got a BCG immunization. However, years later when applying for a job at a nursing home, he was retested and the test was strongly positive. Chest X ray was negative so he was given a course of INH to lower the chance of relapse.
When I got back from Africa, my test was strongly positive, and my chest x ray was negative, and so I too had to take INH for a year.
And our granddaughter Ruby tested positive here in the Philippines and it had to be verified she was on INH before she could get a visa to study in the USA.
Heck, I was required to get a Chest X ray to get a long term visa for the Philippines too. So it's not just the USA, but good medical practice...
How serious could cases of undiagnosed Tuberculosis be?
in 1970, a worker in the US congress cafeteria was found to have open TB,
:WASHINGTON, Feb. 5 (UPI) —Arrangements were made to day to test members of Con gress and about 14,000 Capitol employes for tuberculosis. The action was taken after health officials learned that two Senate restaurant workers died of TB in recent months and that four other active cases of the contagious disease had been found in the Capitol complex.
until HIV hit, few US doctors had seen cases of TB.
I worked for the US PHS, and American Indians had a high risk because of poverty/crowded living conditions. So there was a debate if we should treat everyone with a positive TB test: The risk of hepatitis had to be weighed against the risk of TB relapse. We finally compromised: Treated the younger under 30s, but later we started treating those with diabetes, which also lowered their resistance to TB.
one of the problems with TB is that like other germs it is becoming resistant to medications: people inadequatly treated, people with HIV or poor immune systems who don't clear the germ with treatment etc..
And then there is the problem of seeing mild cases in people with TB scars: Often all you see is a subtle thickening of the cavity scar. I once picked up a case of this in Mescalero, and we transferred the lady for diagnostic bronchoscopy. Initial tests were negative, but the culture did grow multi drug resistant TB.
so we had to put her on a complicated regime. Luckily we were IHS so we arranged for a public health nurse to administer the medicines twice a week. Alas, after six months, the patient developed signs of liver toxicity, either from the drugs or because of alcohol/illicit drug ingestion (she was a known alcoholic but had been sober for a few years when all this happened), but before we could arrange a recheck to see if she still needed the drug, she disappeared.
Finally, one more TB story: Tuberculosis killed several of our relatives including Lolo's father. When he started medical school he was found to have active tuberculosis. Luckily for him, streptomycin had been found to cure TB, and he got some from the local Americans (Legally because he was a veteran, or on the black market? I never asked) and his TB was cured. The bad news? Streptomycin is toxic to hearing, and he had to wear hearing aids.
some educational lectures here: First the history of TB, the second on treatment.
