Tuberculosis has been around for a long time. It was the subject of a famous novel - Thomas Mann's The Magic Mountain. Many more literary people dealt personally with tuberculosis including the poets John Keats, Elizabeth Barrett Browning, and Edgar Allen Poe.
There was a time in United States history when tuberculosis was thought to be under control but more recently with the advent of AIDS making its victims more susceptible to tuberculosis and the development of anti-bacterial resistant strands of tuberculosis, the disease has returned with a vengence.
Mycobacterium tuberculosis is the name of the bacteria causing tuberculosis. The mere presence of the bacteria in a person's body is not considered active tuberculosis. In order to get active tuberculosis, one does have to have the bacteria enter her body, but she also has to develop the tuberculosis disease in her body.
The initial active site of the disease is usually the lungs, and this primary infection developed there usually does so within six weeks of the person's having been exposed to the tuberculosis bacteria. A person with a good immune system and not very young and not very old can usually fight off the initial disease, and build up a wall surrounding the initial infection. When the initial infection is sealed off by a good immune system, the disease goes into latency, and develops only if and when the person's immune system breaks down for some reason or other. Ninety percent of the people who have the primary infection never get active tuberculosis.
There is a vaccine for tuberculosis. It has been around for awhile. The name of the vaccine is Bacillus Camille Geurin (BCG) vaccine. The success rate of the BCG fluctuates, and the vaccine is not recommended for people in the United States except for people in high risk categories. The BCG has had a better success rate reported for children than for adults.
There are also skin tests for tuberculosis. The Tuberculin skin test has been available for approximately a hundred years. One of the drawbacks to the Tuberculin skin test is that the person being examined has to be seen by medical personnel twice – the first time when the test takes place and the second time a few days later when the site of the test must be evaluated by qualified personnel to determine the evaluation of the test—i.e., whether the person has the tuberculosis bacteria in her body. Another weakness of the Tuberculin skin test is that an individual who has had the BCG vaccine will also show a positive reaction to the test even though the person does not have the actual tuberculosis infection.
More recently, a new test has been developed. This test is called the QuantiFeron TB Gold test (QFT-Gold), requires only one reading, and cost about $15.00 for a kit. Since the cost of the personnel is usually an additional $10 per reading, and no second reading is involved, in the United States at least, the QFT-Gold test is comparable in price to the Tuberculin skin test. Another advantage to the QFT-Gold test is that it is not as likely to give false positives to people who have had the BCG vaccine as is the Tuberculin skin test. The QFT-Gold has been approved by the FDA since May of 2005.
Treatment of tuberculosis depends on whether the person has active tuberculosis or just the primary infection. One medication is usually sufficient for people with good immune systems who have just the primary infection. Isoniazid is usually administered for six months for these patients. A more complex combination of medications is given to people who have the active disease or a weakened immune system.
People with a high risk for tuberculosis should be screened as soon as possible once the risk is identified. High risk patients include alcoholics, homeless people, prisoners, personnel at jails, homeless shelters and hospitals, people with diabetes, those with AIDS, etc.
Instructions need to be provided to a person with tuberculosis as to proper precautions such as covering her mouth with a handkerchief when coughing or sneezing. A person with active tuberculosis should be isolated from other patients in an hospital. Proper ventilation should provided in prisons, homeless shelters, and hospitals.
