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A Patient’s Guide to Tuberculosis

Dread of the infectious disease was once universal – tuberculosis used to be called “consumption” because it totally consumed the affected individual. Today – at least in the U.S. – TB is treated with routine antibiotics in most cases and it almost seems like a bygone condition.

In 2018, slightly more than 9,000 new TB cases were reported and the yearly incidence dropped to 2.8 cases per 100,000 people, according to the latest available statistics from the Centers for Disease Control and Prevention.

“It’s easy to view TB as a forgotten disease in the U.S., but it was not that long ago that TB was a primary cause of disease here,” says Dr. Lisa Chen, principal investigator and medical director of the Curry International Tuberculosis Center at the University of California, San Francisco. “Almost every family has a story to tell if you ask grandparents or great-grandparents.”

Globally, by contrast, TB remains an ongoing scourge. In 2018, a total 1.5 million people died from TB, according to the World Health Organization. An estimated 10 million people fell ill with TB worldwide, including 1.1 million children for Tuberculosis.

Multidrug-resistant TB is a public health crisis, according to WHO. Although many national childhood immunization programs use the bacillus Calmette-Guerin vaccine to prevent the spread of TB, the BCG vaccine has limited effects and does not prevent primary infection.

“A big misconception is that TB is gone,” says Dr. Alfred Lardizabal, executive director of the Global Tuberculosis Institute at Rutgers University in New Jersey. “It’s certainly around in the U.S, although obviously not to the degree it was in the first half of the 20th century – but it does still come up and surprise us every now and then.”

Within the U.S, TB distribution is uneven. Four states – California, Texas, New York and Florida – account for about half of new TB diagnoses. However, TB cases crop up elsewhere, reminding communities nationwide that it still exists. In December, a high school student in a small Iowa school district was reportedly diagnosed with TB, as was a middle-school student in Pittsburgh. In November, Delaware public health officials warned of possible TB exposures at a Dover hospital.

Here’s what you should know about TB exposure, diagnosis and treatment.


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