Three factors—
tuberculosis (TB) in immigrants,
human immunodeficiency virus (HIV), and the increasing emergence of drug-resistant bacteria—have made tuberculosis more of a threat in the United States in recent years. Increases in the number of cases and outbreaks of this infectious disease have been a concern since the late 1990s. Tuberculosis is still relatively rare in this country, but it is a large health issue among at-risk groups. Current guidelines call for targeted screening among such groups.
Because of their weak immune systems, infants under 2 years of age are especially susceptible to this infection. If an infant has been exposed to a high-risk individual, he or she should be tested.
The American Academy of Family Physicians’ high-risk category includes those with close contact to a person with known or suspected TB, health care workers, immigrants from countries with a high rate of this disease (generally, less industrialized, developing nations), people with HIV, alcoholics, users of illicit substances, residents of long-term care facilities (such as nursing homes, mental health facilities, prisons, AIDS care facilities, and homeless shelters), and those considered medically underserved or low-income.
The infection may be detected via a tuberculin skin test and/or a blood test. The U.S. Centers for Disease Control and Prevention (CDC) note that more data are needed on the blood test’s effectiveness in children and those with HIV or acquired immunodeficiency syndrome (AIDS).
Links
US Centers for Disease Control and Prevention: Fact sheet on TB
University of Iowa’s Virtual Children’s Hospital: TB
Sources
S1
US Centers for Disease Control and Prevention. QuantiFERON-TB Gold Test (fact sheet). Last modified 16 Nov 2007. Available on the internet through http://www.cdc.gov. Reaccessed 6 December 2007.
S2
University of Iowa Health Care. Tuberculosis. Last modified 19 Oct 2006. Available on the internet through http://www.uihealthcare.com. Reaccessed 6 Dec 2007.
S3
D’Alessandro D and Huth L. Pediatrics common questions, quick answers: TB (tuberculosis). Last revised Apr 2002. Children’s Virtual Hospital and The University of Iowa. Available on the internet. Reaccessed 6 Dec 2007.
S4
History of TB: the recent TB epidemic. 26 Feb 2001. New Jersey Medical School and National Tuberculosis Center, University of Medicine and Dentistry of New Jersey. Available on the internet through http://www.umdnj.edu. Reaccessed 6 Dec 2007.
S5
US Centers for Disease Control and Prevention. Targeted tuberculin testing and treatment of latent tuberculosis infection (American Thoracic Society/CDC statement). 9 Jun 2000. MMWR 49(RR06);1-54. Available on the internet through http://www.cdc.gov/mmwr/. Reaccessed 6 Dec 2007.
S6
Tuberculosis. In: Caring for Your Baby and Young Child: Birth to Age 5. 1999. Bantam. Excerpt available on the internet through http://www.medem.com. Reaccessed 6 Dec 2007.
