(Location: California, USA)
Every now and then, the local news & local government announces that a TB case has been identified in the community, and it gives a list of possible locations & times at which people maybe have been exposed to it.
Example: Active TB case identified at X Gym. Possible locations include ABC train route, DEF school, XYZ grocery store…
Why is contact tracing for TB so much more serious than the flu or common cold?
In: Biology
TB is more fatal and deadly than the cold or flu. In Victorian Britain it killed people in their 1000s every year.
The film Moulin Rouge has a main character dying of it.
When people are sick with it they are also contagious and can spread it to others, they need to be isolated to prevent it spreading into the community at large.
TB spreads airborne (coughing, sneezing) so it’s quite infectious if given some time with the sick person. It also always exists among some distinct groups of population, especially the homeless, heroin addicts and incarcerated. So, while virtually non-existent among *general* population, it takes very little for it to get into masses. And as other replies have said, cases can be severe to lethal.
Would you ask the same question about Ebola?
Wikipedia says that about 10% of TB infections become active, and of those about 50% are fatal.
That’s pretty damn nasty. Way worse than a cold or the flu.
Tuberculosis (old timey name “the consumption”, if you read victorian/colonial setting books there’s probably at least one background character dying/dead from it in your protagonist’s family or social circle) gradually destroys the lungs – as in, “eats actual caverns into your lung tissue until you have none left” – until you choke to death. With antibiotics it is no longer a death sentence, but if you get it there is still approximately as much chance of dying from it as from a single round of russian roulette.
It’s a pretty deadly disease (>1 million deaths globally per year) that can be spread relatively easily in densely populated areas and requires a long treatment course to eradicate. Unlike normal bacterial infections, where you can take an antibiotic for a week or two and then you’re good, the TB bacteria is covered in an almost wax-like coating which makes it hard to kill. It requires a combination of a few different antibiotics for the span of months, with these antibiotics having some annoying side effects. You could imagine that it could be challenging to coordinate in resource poor areas in the world, which is where the disease burden is the highest.
It’s also challenging to get rid of because many people have the TB bacteria in their system, but it’s not actively causing symptoms. This is known as latent TB, and it can be reactivated when there’s some sort of shakeup to the immune system, like a new immune modulating drug or HIV infection. These people might not even know it’s in their system. This is why people get tested with a skin prick, blood test, or chest X-ray before working in a hospital or other healthcare facility before hand. It’s also why you have to get tested before starting certain medications which alter your immune system.
I’m working in IT in the financial sector. We had an Indian consultant from an outsourcing partner come work on site here in Denmark.
The guy used to look well-fed, but seemed to have lost a lot of weight in the recent year or so. He also had some problems with his respiration. He was not looking well during the 6 months he was here. He refused to go see a doctor even though we told him he probably should be checked, allegdely because he didn’t trust doctors here or because he feared that it might be expensive (it would be free).
Eventually his wife (who was with him on site) made him go to the doctor, when he started to be very ill and having episodes of incoherence. The GP immediately admitted him to the hospital.
Within 2 weeks he passed away. Turned out he had untreated TB, that had eventually spread to his spine and brain. There was nothing they could do to save him at that point. If he had gone to the doctor when he started having respiratory problems (in India where they’re probably much more familiar with cases of TB) or even when he arrived here, he probably could have been treated before the condition turned fatal. Because he didn’t want to go to a doctor, a promising young man passed away at 24 years old.
Tuberculosis is a very deadly disease, at one point it was one of the leading causes of death on the planet. Ever read an old book and they talk about “consumption”? That was tuberculosis. Today it is the leading cause of death for people that are HIV+. Tuberculosis is caused by a bacteria and while we have antibiotics that can work on it drug-resistant TB is unfortunately becoming more and more common.
TB is also dangerous because it can go dormant inside your body, it looks like you’re no longer sick, you no longer have symptoms, but the bacteria are still there just waiting for an opportunity to come back with your immune system isn’t working as well, like if you’re sick with something else or receiving treatment for cancer or taking immune-suppression drugs to treat HIV.
So if you’ve been exposed it’s important to know that you may become sick or if you could be an asymptomatic carrier of the disease that could spread it without ever knowing you’re sick.
One thing I haven’t seen mentioned is that in addition to be fatal if untreated, TB is also tricky to treat. You have to take daily medication for months possibly up to a full year. If it’s drug resistant TB is can take over two years to treat.
Tuberculosis is a bacterial infection that spreads slowly and kills about half of people that are untreated. TB is already resistant to many antibiotics because of the bacteria’s unique cell wall. Any bacterial infection can become antibiotic resistant when antibiotics kill some but not all of the infection – that means that there’s fewer and fewer tools for doctors to use to treat it, and that happens in TB. TB spreads from inhalation of droplets containing the bacteria, and spreads pretty well in people with close contact to an infected individual. What’s more tricky is that you become infectious enough 3-4 weeks after your infection, which makes tracing backward to the first patient hard.
So yeah, it’s more serious, harder to treat, and hard to detect.
On top of what everyone already said, USA doesn’t commonly vaccinate for TB anymore, and you have a lot of immigrants and tourists who can also be unvaccinated. With how easily spreadable it is, amongst a group without any antibodies and no herd immunity, it can SO easily be a catastrophe.
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