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Please Explain: Tuberculosis

Friday, January 13, 2012

Tuberculosis remains one of the world’s deadliest diseases—accounting for 9.4 million cases and 1.7 million deaths in 2009, according to the WHO. Maryn McKenna, science journalist and author of Superbug, and Dr. Neil Schluger, Professor of Medicine, Epidemiology, and Environmental Health Sciences at Columbia University Medical Center and Chief Scientific Officer for the World Lung Foundation, give us a history of the disease, how it spreads, why it’s so hard to treat, and how drug-resistant TB has emerged and what it means for the future of treating the deadly disease.

Guests:

Maryn McKenna and Dr. Neil Schluger

The Morning Brief

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Comments [27]

Susan from NJ from Millburn, NJ

I am commenting on Larisa's question. My relative was in a DP camp as a young child and was just diagnosed with a MAC infection. Not sure how we can get in touch to compare notes. My relative has just started the treatment.

Jan. 13 2012 04:08 PM
Amy from Manhattan

YIKES!!!: Ask one of the people involved in your care. But the same precautions you take to avoid other incfectious diseases should be at least as effective against TB.

Dano: TB isn't inherited genetically, so children don't get it from their parents except through inhalation while the parents have active TB.

Jan. 13 2012 02:15 PM
Richard from New York City

Question on preventive care for latent TB. I have it & started a protocol a few years back but had to stop because of numbers too high in liver tests. Should I give it another shot? Your guest, Dr. Schluger, mentioned that most of the people exposed usually develop active TB within "a few years". I am long past that and am told that the French [medical establishment[[ believes that American doctors "over-treat" latent TB given the low incidence of inactive TB turning active. Your thoughts? - r. [The start of the aforementioned protocol coincided with a college reunion where alcohol was an active part of the mix. Hence, the question about trying again absent that factor.]

Jan. 13 2012 02:10 PM
anonyme

Here's something else - beef ourselves up with alternatives like the aforementioned energy medicine or acupuncture or other effective immune-strengthening regimens + diets that help balance/enhance gut flora that do really strengthen us but aren't in the allopathic world/paradigm yet.

Don't you remember reading about perfume makers who didn't get the plague - we need to look harder for options if we are going to keep growing these resisting bacteria and viri!!!!

Jan. 13 2012 01:56 PM
Cori from NJ

There is a large, ongoing, body of research on tuberculosis and Vitamin D. Can your guests comment? Thanks.

Jan. 13 2012 01:53 PM
Amy from Manhattan

One of the guests mentioned that Nelson Mandela got TB in prison. Could the guests talk about how TB spreads best in enclosed places where people can't come & go for long periods, like prisons & even hospitals (although the latter now take better precautions). And could they also discuss DOTS (where someone is sent to observe TB patients in their homes & make sure they take their drugs every day, to prevent its spreading)? Is that still being done?

Jan. 13 2012 01:52 PM
blaine from bushwick

I test "false positive" for TB due to an old exposure. I was told by a doctor that I shouldn't get the skin test anymore, but instead get an x ray if needed. is that true?

Jan. 13 2012 01:52 PM
Steve from Queens


I am from Belize in CA. Back in the late 60s we had a hurrican and the military gave every one shot for different things.
When I came to the US in 1962 I had take some medication for about a year. Then in 1995 someone at my company had TB and we all got tested and I had to go for more testing, nothing was found.
But they said it as because I had TB shots back in the 60s make it show up in my last test.
Can this be correct?

Jan. 13 2012 01:52 PM
Dano from Kearny, NJ

Does it affect your DNA? Can offspring get it?

Jan. 13 2012 01:51 PM
kp from nj

Maybe another 'please explain' segment should be done on antibiotic resistance in general...Calvin Coolidge's son died in the 1920's because he played tennis without socks, got a blister that became infected and the infection killed him because antibiotics had not yet been discovered. Most folks don't have a great understanding or appreciation for what antibiotics do for us...

Jan. 13 2012 01:50 PM
Aubrey from Cleveland

I have a homeless friend that had a positive test of TB exposure at least 5 years ago. He took a few weeks of the treatment and then quit. I like to have him stay in my home when it's REALLY cold out-- about 5-10 times per year. Is this dangerous to my family? He claims that in that latent form he is safe to be around and that he monitors his health and hasn't had any symptoms of TB.

Jan. 13 2012 01:50 PM
Gaby from Jackson Heights

How many of the US cases are in our prisons?

Jan. 13 2012 01:50 PM
Adda from New York

What about people who are resistant to TB? I had a grandfather who was able to work with TB patients since he seemed to be immune to the disease. Do doctor's know how that can be?

Jan. 13 2012 01:47 PM
Lnada from NYC

Just to clarify...
I think many WNYC listeners know "Many Famous People" who got and even died of TB...but we're in 2012 and people "with means" (like George Michael in Austria) are thankful for surviving this disease.

I don't have health Insurance and I shutter to think of where I would be if I got this thing. Health Insurance and access to care seems to be imperative. maybe even good ol' fashioned - Luck.

Jan. 13 2012 01:46 PM
cynthia ehrenkrantz from white plains, ny

I heard that part of the successful treatment of tb was attributed to the use of "barefoot doctors", first in India and then in the UK. These people monitored peoples' medication to see that they stayed with the treatment for the prescribed length of time and they were paid for their services. Margaret Thatcher, as part of her "cutback" program eliminated the use of these monitors and TB recurred in the UK.

Jan. 13 2012 01:43 PM
YIKES!!!

OMG I am one of those immune compromised patients (cancer is an epidemic now you know) - I am assuming patients are routinely tested for TB and all kinds of other factors before cancer treatments begin! Do you know about this???

Jan. 13 2012 01:43 PM
Hannah from Greenwich Village from Manhattan

Two years ago on a flight back to U.S. from South Africa, I was apparently exposed to the bad TB kind along with everyone else on the airplane.

We were all contacted through NYC Health Dept, but IT TOOK THREE MONTHS FOR THEM TO CALL me in for alert/testing.

It was simply shocking how long the CDC took to contact NYC Health Dept and for them to contact passengers. The system here has not been truly tested under fire so we don't know what would happen. The upside: At least, they did the tracking. (The lack of confidentiality at the NYC Health Dept is another story and how they handled it was truly alarming if I had caught something.)

Jan. 13 2012 01:42 PM
John A.

I believe that in the general marketplace there exists the concept of the "Halo product", one that need not produce profit, but gives the corporate image a boost. Hope medical companies use this concept more often (before they are straight-out hated).

Jan. 13 2012 01:42 PM
Anna from Eastchester NY

PPD positive and Quantiferin Assay negative
Means there is no TB infection.
No medication or CHest X-ray needed
Right ?

Jan. 13 2012 01:38 PM
kp from nj

The Dr. makes a great point about drug companies wanting to find the new lipitor and not a new antibiotic, I totally agree...maybe the 'free market' doesn't always have the right answer....

Jan. 13 2012 01:37 PM
kryssie from Jersey Shore

My 20 year old son tested positive with the two step TB test he needed to have for an internship in a Microbiology lab. He was told he had to take this awful antibiotic isoniazid for nine months. He is still in denial five months into the drug treatment. His chest xray was clear. How could he have been exposed? Why treat him if his xray is clear? Now this will follow him throught his medical career. I wish there was better testing.
The antibiotic Isoniazid is awful and you have to be on a strict diet while taking it. My son has lost 10 pounds since he had to give up some of his favorite foods like olives and Asian foods (soy sauce).

Jan. 13 2012 01:35 PM
Richard

Is there higher incidence of TB in the US among persons infected with HIV, even with drug treatment for HIV keeping viral load undetectable? Is higher viral load and/or lower T-cell level associated with TB vulnerability?

Jan. 13 2012 01:34 PM
anonyme

Leonard - an interesting alternative take on TB is Donna Eden's (author of Energy Medicine with David Feinstein) - her motehr sued to self-cure in the 40s - Donna got it as a little girl and self-cured and grew up to then cure herself (and others) of MS - all from the point of view of energy medicine.

Jan. 13 2012 01:33 PM
kp

The first antibiotic effective against TB as discovered at Rutgers University by Dr. Selman Waksman. He isolated streptomycin from a soil microbe, Streptomyces and won the Nobel Prize.

A Rutgers Alumna (and mycologist)

Jan. 13 2012 01:29 PM
Landa from NY

george michael had some crazy TB strain that he, a wealthy westerner, said was touch and go. he said the DRs who treated him in Austria were very prepared to treat his severe strain of TB. we nearly lost him to this. if GM could "nearly" go, what does bode for others.

Jan. 13 2012 01:28 PM
Ed from Great Neck

What generally triggers TB from it's latent to active state?

Jan. 13 2012 01:23 PM
RJ from Prospect hts

I believe the problem is worse than what is suggested above. there is not only multidrug-resistant TB (MR-TB) but *extremely* multidrug-resistant TB (XMR-TB) throughout the world, in places where people have difficulty getting and/or taking sufficient quantities of the medicines for treatable diseases.

Plus, there is an insufficient amount of capacity for basic science and clinical study of these MD- and XMD-TB cases in order to devise new treatments.

Jan. 13 2012 01:22 PM

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