Forgotten (almost) but not gone, tuberculosis suddenly looms large on domestic scene
Article Abstract:
The incidence of tuberculosis (TB) is increasing in the United States, and its status was recently reviewed at the World Conference on Lung Health, in Boston. Part of the increase in the number of cases is the result of adoption of children born in Third-World countries. One study found that the prevalence of tuberculosis in 301 such adoptees was more than 100 times greater than that of a comparable group of American-born children. Currently, children do not receive routine screening for TB, but pediatricians need to be aware of the special health problems of the estimated 8,000 adopted children from abroad. American-born children at risk for TB include black and Hispanic children, and all races of children of migrant farm workers. In the latter group, BCG vaccine is recommended. However, it is not only the youngest immigrants who may be infected; presently, between 10 and 15 million Americans are infected with TB, with the greatest numbers of cases concentrated in the East. These increases are due largely to the prevalence of TB in people infected with the human immunodeficiency virus (HIV), the virus associated with AIDS. In patients infected with HIV, TB is hard to diagnose because the chest lesions appear different on X-ray than in people not infected with HIV. Furthermore, the disease occurs in sites other than the lung in 40 percent of HIV patients. Estimates of the number of TB-infected AIDS patients run as high as five percent, and the AIDS-TB combination constitutes an emergency situation. Opinions regarding the infectivity of TB differ. Since advanced HIV infections can cause a TB skin test in an TB-infected person to read negative, early TB testing of HIV-positive people is recommended. If a TB test is positive, AIDS patients undergo treatment with isoniazid (a drug for treating tuberculosis) for nine months instead of the usual six. If untreated, TB can hasten the progression of AIDS. The incidence of new TB cases in the US is frightening, but the situation can be controlled with appropriate therapy, the use of field workers who serve the needs of the affected groups, improved prevention, and research. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1990
User Contributions:
Comment about this article or add new information about this topic:
Even 'in perspective', HIV specter haunts health care workers most
Article Abstract:
In April 1990, the first Hopkins Conference on AIDS (acquired immunodeficiency syndrome) was held, which was sponsored by The Johns Hopkins Medical Institutes. A focus of the conference was the risk of infection by human immunodeficiency virus (HIV, which is associated with AIDS) in health care workers. Comparisons were made between HIV risk and risk of infection by hepatitis B virus, another hazard to health care workers. No work-related deaths among health care workers have yet been report in conjunction with HIV, although 27 cases of infection are known. (Eight of these cases, reported by the Centers for Disease Control, are now being published.) Of the 19 cases of documented HIV-seropositive (blood test which indicates HIV infection) individuals, each infection was associated with exposure to HIV-contaminated blood. Between September 1986 and August 1987, the Occupational Safety and Health Administration estimated there were 167 to 202 deaths of health care workers due to occupational exposure to hepatitis B virus. Lack of adequate immunization for hepatitis B has, thus far, been a larger problem than HIV infection. It is anticipated that mortality from HIV infection will not reach comparable statistics for some time. San Francisco General Hospital has devised an experimental protocol for health care workers to follow if they are exposed to HIV: decontaminate the wound with soap and water; take prophylactic zidovudine as soon as possible; and obtain counselling from the Needlestick Hotline. (A factor to be considered is the potential toxic effects of zidovudine, which can cause birth defects.) This procedure should be followed-up with tests to determine the HIV status of the worker. Health care workers are advised that if they rigorously follow all guidelines for protection from blood-borne disease, their risk of infection will be very low. However, constant vigilance is necessary. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1990
User Contributions:
Comment about this article or add new information about this topic:
Medical exorcism required as revitalized revenant of tuberculosis haunts and harries the land
Article Abstract:
Tuberculosis is making a comeback, and the president of the American Lung Association (ALA) says the only way to control the disease is to make sure that TB patients take their medication on a regular basis. Lee B. Reichman says the lack of an infrastructure to treat TB patients has lead to the rise of drug-resistant strains. The HIV epidemic, immigration, homelessness and drug abuse have also contributed to the rise in TB cases. Many doctors may have forgotten how to treat the disease, which had been declining steadily until the 1980's. The ALA has recommended that Congress allocate $355 million for TB research in 1993, which is 15 times the amount spent in 1992. Twenty million people worldwide have active TB, and 26,283 new cases were reported in the US. The highest TB rates occur in New York, Hawaii, California, Texas and Georgia.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1992
User Contributions:
Comment about this article or add new information about this topic:
- Abstracts: Forgotten exercises for delts & traps. Tricks for growing a bigger chest, back and shoulders. Cannonball delts
- Abstracts: Outcomes research will lead to better care, supporters say. Battle lines are drawn on Dr. Elders' nomination
- Abstracts: A prospective study of exercise and incidence of diabetes among US male physicians. Sugar-sweetened beverages, weight gain, and incidence of type 2 diabetes in young and middle-aged women
- Abstracts: Mitral annular calcification and the risk of stroke in an elderly cohort. Parental Atrial Fibrillation as a risk factor for Atrial Fibrillation in offspring
- Abstracts: Family medicine