During the 19th century, TB claimed more lives in the United States than any other disease. But, with improvements in nutrition, housing, sanitation, and medical care during the first half of the 20th century, the number of cases and deaths dropped dramatically. In the 1940s and 1950s, with the introduction of antibiotic therapies for TB, the decline continued. By 1985, the number of cases had fallen to the lowest figure recorded in modern US history.
However, TB re-emerged as a serious public health problem in the US, with more than 25,000 active TB cases reported in 1993, an increase of 14 percent since 1985. Between 1992 and 1998, the number of reported TB cases declined 31 percent. However, in addition to those with active TB, an estimated 15 million people in the US have latent TB infections that may develop into active TB at some time in their lives.
A number of differing factors are cited as the reasons for the increase in cases of tuberculosis:
The TB crisis has been intensified by the emergence of disease caused by multiple drug-resistant organisms (MDR), which may cause an essentially incurable form of the disease.
Tuberculosis (TB) is a chronic bacterial infection that usually infects the lungs, although other organs are sometimes involved. TB is primarily an airborne disease.
There is a difference between being infected with the TB bacterium and having active tuberculosis disease.
There are 3 important ways to describe the stages of TB. They are as follows:
The predominant TB bacterium is Mycobacterium tuberculosis (M. tuberculosis). Most people infected with M. tuberculosis never develop active TB. However, in people with weakened immune systems, especially those with HIV (human immunodeficiency virus), TB organisms can overcome the body's defenses, multiply, and cause an active disease.
TB affects all ages, races, income levels, and both genders. Those at higher risk include the following:
The following are the most common symptoms for TB. However, each individual may experience symptoms differently.
The symptoms of TB may resemble other lung conditions or medical problems. Consult a physician for a diagnosis.
The TB bacterium is spread through the air; however, repeated exposure to the germs is usually necessary before a person will become infected. It is not likely to be transmitted through personal items, such as clothing, bedding, or other items that a person with TB has touched. Adequate ventilation is the most important measure to prevent the transmission of TB.
TB is diagnosed with a TB skin test. In this test, a small amount of testing material is injected into the top layer of the skin. If a certain size bump develops within two or three days, the test may be positive for tuberculosis infection. Additional tests to determine if a person has TB disease include x-rays and sputum tests.
TB skin tests are suggested for those:
Recommendations for skin testing in children, from the American Academy of Pediatrics are as follows:
Immediate testing:
Yearly skin testing:
Testing every 2 to 3 years:
Consider testing in children from ages 4 to 6 and 11 to 16 if:
Treatment for tuberculosis:
Specific treatment will be determined by your physician based on:
Treatment may include:
Treatment may last for many months. However, once the treatment begins, the patient begins to feel well very soon. The patient is not usually contagious once treatment begins, provided that treatment is carried through to the end, as prescribed by a physician.
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