Submitted by Diana T. Yu, MD MSPH
Let’s Eliminate TB In Our Lifetime
Tuberculosis (TB) may be an old disease but it is very much in the present. Why should a person living in Thurston County need to know or care about TB? When a person is exposed to the TB germ, by breathing, after someone with contagious TB has been coughing, the TB germ can enter your lungs and cause an infection. If you are healthy, the germ may sit there for years without causing any problems. As you age, or have problems with your health or become immune compromised, the TB germ “wakes up” and starts to cause disease. With TB, an infection is not contagious but disease in the lungs or throat definitely is contagious.
You should be aware of what your risks are for exposure to Tuberculosis. Did someone you live with have active TB disease? Were you born in or have you traveled and lived in a TB endemic country (anywhere other than US or Canada)? Discuss this with your health care provider. If recommended, consider taking preventive medications while you are relatively younger and healthier.
In 1882, Dr. Robert Koch discovered that Tuberculosis was caused by a bacteria. In the mid- 1950s-60s several medications were found to effectively kill the TB germ when taken together. By the mid-1980’s the elimination of Tuberculosis as a worldwide scourge seemed to be within reach.
In the United States, cases of TB were on the decline, leading to changes in attitude towards TB control, complacency, diversion of funding for TB control and mismanagement of active TB disease cases. As TB controllers in the US put in a mega effort to control TB, we have seen the cases now decreasing steadily again since the mid-1990s.
BUT, millions of people still become infected every year with TB. Newer, drug resistant, extremely drug resistant and totally drug resistant cases are emerging. Research and development into effective treatment, or newer drugs against TB are not a priority. The advent of Human Immunodeficiency Virus was another major blow. A majority of the cases of TB disease in the world occur in developing countries. Many are co-infected with TB and HIV. So why should someone in the US care about elimination of TB in the world?
We live in an increasingly global society. People travel around the world for work, to visit family and friends or for pleasure. “Exotic diseases are only a plane ride away.” The fact that Tuberculosis is spread by someone with the contagious disease, through the air we all need to breathe, makes it hard to avoid. Because medications and disease control measures cost more than some country’s GNP, many of these developing countries cannot fight this disease without aid.
On the domestic scene, the many years of not paying attention to the risk of Tuberculosis is starting to take its toll. Baby boomers are approaching their 60’s and 70’s, and are experiencing health problems like diabetes (a risk factor for activating TB disease). They may have been exposed to and infected by relatives in their homes who had Tuberculosis, in an era where there was no treatment for disease or medications for prevention.
If you have TB infection, know the signs and symptoms of TB and seek care from your local health department if you have unexpected weight loss, cough, fever, or night sweats. Working together we can eliminate TB in our lifetime.
I would love to celebrate in the near future a “World No TB Day”
