Well, first off, TB can be present in different part of the body. If you are speaking of pulmonary TB- in the lungs, then here if what I know: It depends upon the location of the lesion in the lungs, and the severity of the symptoms. If this guy is still working, and not in isolation in a hospital somewhere, then you shouldn't have anything to worry about. Treatment is very long! Usually 6 months to a year of multiple medications. Generally only contagious until about a month of treament with anti-tuberculosis medications. Symptoms of pulmonary tuberculosis are cough, fever, night sweats, fatigue, loss of appetite, and weight loss. Just ask the guy! As I said, if he's out and about, and not in the hospital, then he can't be contagious, as they legally and ethically cannot let him out in the public if he poses a health risk.
2006-09-16 09:57:30
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answer #1
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answered by tntwade 3
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Tuberculosis has been infecting our human populations for well over 3,000 years. It is truly a global menace with remarkable staying power. Today, this bacterium infects some one-third of all humans worldwide. In 2005 alone, 9 million will be diagnosed with the infection and more than 2 million will die. 1,2,3 During this same year, about 40 million, most unknowingly, will quietly become infected. 4 Mycobacterium tuberculosis, which is the name of the bacterium that causes most cases of tuberculosis, will lie latent, awaiting a future time and place to awaken. Eighty percent of these new cases will arise in just 23 countries, and more than half will be localized to just 5 nations: Bangladesh, China, India, Indonesia, and Nigeria.
In the United States, we’ve been making progress since 1992. In fact, there are some who believe eradication of tuberculosis in the United States by 2010 is possible. This is unlikely considering that 14,500 new cases were identified in 2004 and mass travel and immigration, legal or otherwise, makes the world’s TB problem, America’s problem. At special risk, in addition to recent immigrants, are those with HIV, the homeless, and the imprisoned. These conditions effectively deliver an environment of immune deficiency, crowding, poverty, and poor ventilation.
Tuberculosis, like many infectious diseases, does not respect geographic borders and rides on the backs of the vulnerable. It is a significant contributor to the global burden of disease and is well suited for intercontinental travel with long, symptom-free latency periods and successful aerosol transmission. Migration and immigration, combined with less than perfect testing, means cases get by, even with screening.
The familiar tuberculosis skin test, known as TST, has been utilized since 1930. 4 It is viewed by most as an imperfect but familiar standard. Its issues include variability in reading and follow-up of results, false positives and negatives, and inadequate sensitivity for some high-risk populations such as those who have had prior BCG vaccination for TB prevention. Testing was also spotty until 1993 when the Centers for Disease Control and Prevention recommended standard testing for all vulnerable populations. The case with homeless populations is instructive. In 1993, the CDC asked health departments to provide annual reports of TB incidence in area homeless. In the past decade, they have achieved 90 percent compliance. Data has revealed common risk factors, including being male, having a history of incarceration, having a history of substance abuse, and being HIV-positive. From this data, new directives requesting testing of all homeless with rapid-result 20-minute tests were issued. To execute this strategy, three target sites have been identified for testing – shelters, emergency departments, and jails. The last is a common transit site for the homeless with 49 percent having been incarcerated for five or more days at some point in their lifetime.
The current focus on latent TB infection in the United States is understandable. Active infection rates have been declining since 1992, but eradication is clearly impossible unless the huge latent population is identified early and treated. Treatment, for both active and latent infections, is effective if adhered to. Standard treatment for active infections takes 9 months and involves four drugs for two months – isoniazid, rifampin, pyrazinamide and ethambutol – and two drugs – isoniazid and rifampin – for 7 months. As one might imagine, adherence to such a demanding regime is a challenge. That is why health departments support DOT, or Direct Observational Therapy, in which the patient is administered his or her medication by a health professional and is observed taking the medication. Not only does this ensure the effectiveness of the therapy, it also prevents TB from becoming drug resistant, already a problem with 2 percent of patients in California.
Treatment for the latent infection is the drug isoniazid for 6 months. If this effective therapy is to have a chance, we need better tests to uncover those harboring infection. 6 New tests are in the works. They’re extremely sensitive in all target populations, they’re accurate with low false positives and negatives, and they’re both reliable and consistently objective. The lead contender is the interferon gamma test that exposes the presence of mycobacterium tuberculosis by detecting the cellular immune response to it by T helper cells and interferon gamma.
But to beat TB, we’ll have to go beyond U.S. pools of latent infections, attack TB worldwide, and expand the roles of doctors and nurses. As TB experts Dr. Philip Hopewell and Dr. Madhukar Pai recently noted in the Journal of the American Medical Association, “All clinicians who undertake treatment of patients with TB must recognize that they are assuming an important public health function that entails responsibility to the community as well as to the individual patients in their care.”
The goals are clear: prompt diagnosis, increased awareness, treatment support, decreased stigma, and adherence to therapies. The standards of care? First, identify the vulnerable and test them. Second, treat and supervise. Third, evaluate for HIV and substance abuse. Yes it is transmittable and it affects the lungs. Hope this helps you out hun........Flo
2006-09-16 16:04:52
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answer #8
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answered by flo 3
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