While adoptions and immigration come under specific TB testing requirements, many people are questioning if this is enough.
International travel operates under CDC recommendations for precautionary measure, but doesn’t require mandatory testing.
With the increase in multidrug-resistant TB, there could be a global crisis in the near future (1).
Some 2015 Tuberculosis Outbreaks
So far in 2015, there have been several TB outbreaks in the US that have involved schools and churches.
In March 2015, a tuberculosis outbreak occurred in Olathe, Kansas. 27 people at the Olathe Northwest High School tested positive for tuberculosis (TB) infection. They were exposed to TB after coming into contact with an infected student. When the student was diagnosed, the school of more than 300 students and staff were immediately tested (2).
Those 27 people were symptom free and non-contagious. However, without treatment, their conditions would have deteriorated as the bacterium took hold and advanced into tuberculosis disease.
In June 2015, a TB outbreak occurred in a Clark County, Indiana school. 48 people tested positive for TB skin tests at the Rock Creek Community Academy. It began just before Memorial Day with a “confirmed case of tuberculosis at Rock Creek” (3).
In May 2015, Texas Department of State Health Services (TDSHS) confirmed four new cases of exposure to a student diagnosed with TB at Kilgore College in Gregg County and 60 people were tested for TB (4).
In June 2015, approximately 100 people in Clovis Community Choir and the Clovis Lions Club between October and April were potentially exposed to TB. Patient zero, a male, was diagnosed and began treatment for TB in April  (5).
Tuberculosis Symptoms and Infection Risk
TB is highly contagious through simple airborne contact, such as a cough, sneeze or even talking with the infected person. Transmission of the infection occurs when the bacterium is sent into the air by the infected person and inhaled by the other person.
According to the World Health Organization (WHO), “Although TB is not usually spread by brief contact, anyone who shares air with a person with TB disease of the lungs in an infectious stage is at risk. A person who inhales one or more of the droplet nuclei can become infected with M. tuberculosis” (6).
TB disease symptoms:
–> Bad cough lasting 3 weeks or longer
–> Chest pain
–> Coughing up blood or sputum
–> Weakness or fatigue
–> Weight loss
–> Loss of appetite
–> Night sweats
The CDC states that most healthy people are able to fight off the infection, but the TB bacteria can still live in the body in what’s known as “latent TB infection” (7).
Latent TB patients are symptom free and non-contagious; however, the TB bacteria can “become active in the body and multiply…” That is when “…the person will go from having latent TB infection to being sick with TB disease.”
Anyone with a compromised immune system, such as HIV/AIDS (Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome), diabetes and other diseases are more susceptible to TB and less likely able to fight off the bacterium.
There are several preventative measures in place for known risks of TB. These include adoptions from foreign countries, immigration and US citizen traveling outside the country. These all include testing for TB.
Immigrants to the US are tested for TB and other diseases in their country prior to leaving as are adoptive children (8).
The CDC advises international travelers to avoid unpasteurized dairy products because of bovine tuberculosis (M. bovis). According to the CDC, the world regions that pose the highest risk to travelers include, “areas of sub-Saharan Africa, Asia, and parts of Central and South America” (9).
For US citizens traveling outside the country, the CDC recommends testing for TB if the person has frequent contact with hospitals, clinics, prisons and homeless shelters where TB is prevalent. Those who spend time in these populations are recommended by the CDC to test for TB prior to traveling outside the US and then repeat the test 8-10 weeks after their return to the US.
Harsh statistics reveal the prevalence of TB in the world. The CDC reports that “Globally, nearly 9 million new TB cases and nearly 1.5 million TB-related deaths occur each year.” Worldwide, TB is the second common cause of death, with HIV as the number one cause. People with HIV/AIDS are most susceptible to TB, which is the number one cause of death among HIV patients.
The CDC doesn’t endorse the TB vaccine. “Bacille Calmette-Guérin (BCG) is a vaccine for tuberculosis (TB) disease. This vaccine is not widely used in the United States, but it is often given to infants and small children in other countries where TB is common. BCG does not always protect people from getting TB.”
In fact, the CDC states it “does not recommend it [TB vaccine] for travelers,” and that “the vaccine has limited effectiveness at preventing TB” (9).
With the world shrinking through frequent international travel along with the influx of “undocumented” immigrants who have not been screened for TB, the possibility of more TB outbreaks is considered highly likely.
References & Image Credits:
(1) TSW: Is a Drug Resistant Tuberculosis Becoming a Global Concern
(3) News and Tribune
(4) Kilgore News Herald
(5) Lubbock Online
(8) CDC Factsheet
(9) CDC: Tuberculosis
(10) Wikipedia: Tuberculosis