Healthy Concerns By David McAtee, Prescott, AZ firstname.lastname@example.org Issues concerning health and preparedness in Yavapai County brought to you by the Yavapai County Community Health Services, Community Relations and Public Information Officer.
Thursday, April 12, 2012
TB or not TB: What is the difference?
By David McAtee
Maybe it is because March 24 was World TB day, but for some reason the Health Department has been getting calls from people who see someone working with what appears to be a positive TB skin test or a raised red area on the forearm, and call us with their concerns.
Concerned for themselves, as well as the other guests, they contact the Health Department and ask why we haven't stepped in and removed the "sick" worker. So, in celebration of World TB day, I thought this would be a good time to explain tuberculosis (TB), and TB skin tests, in a way that anyone can understand.
I am a story teller by nature, so with a little help from our Public Health Nurse (TB Control Nurse) here is the scenario that I think will help explain TB.
Guy walks into a bar, (I know, how cliché) and orders a drink and a hamburger for lunch. This is a small bar in the downtown area, so the waiter is also the cook and head bottle washer. As he is taking your order you notice a small raised bump on his forearm. Being the concerned citizen you are, you ask "Hey how did you get that red bump on your arm?" The waiter, looking somewhat tense, now says "Well, um, I kind of got a TB test and they say it is positive. Don't worry or nothing, I'm not sick." Not feeling terribly reassured by the waiter's response, Guy calls his nurse friend to get the skinny on positive TB skin tests.
Nurse friend asks, "Did he look sick?" "No, but TB is deadly isn't it? Should that guy be serving food?" Nurse friend realizes she has a lot to explain and suggests Guy come over after work. Guy arrives and the education begins.
Nurse tells Guy, "TB usually attacks the lungs but can exist in the kidney, spine, or the brain, and yes if not treated properly can be deadly. TB germs travel through the air when a person with TB disease of the lungs or throat coughs, sneezes, speaks, or sings. TB is NOT spread by: shaking someone's hand, sharing food or drink, touching bed linens or toilet seats."
Guys asks "Well then how does it get spread?" Nurse, "When the TB germs enter the body of a healthy person the body goes to work and tries to kill the bad stuff with white blood cells. If they can't kill the germs they surround it with a protective casing of white blood cells to keep it from growing. This normally causes the germs to go to sleep. This is called Latent TB. People with latent TB infection are not sick and cannot spread TB germs to others." Guy is looking somewhat relaxed now.
Nurse continues, "However, if TB the germs become active in the body and multiply, the person will go from having latent TB infection to being sick with TB disease. This happens when a person, who has been previously infected with TB, is suffering from a weakened immune system or their body just can't keep the TB germs asleep and the germs are allowed to grow." Guy is no longer looking relaxed.
Guy, "How can I know for sure I didn't just get TB?" Nurse, "There are two kinds of tests that are used to detect TB germs in the body: the TB skin test and TB blood tests. Both of these tests are asking the body if they have seen these TB germs. If the results of either test come back positive, a medical history, physical examination, chest X-ray, and other lab tests may be needed to check for active TB disease. If active TB Disease is found, treatment will be started."
Guy quickly remembers that his co-worker had a positive skin test a few months ago. "Could I have gotten TB from a co-worker?" Guy asks almost desperate at this point. Nurse, "First of all, keep in mind that nearly one in 3 people in the world have latent TB. Secondly, Do you work very close together, in a small room, with very little ventilation? Does your co-worker have a wet productive cough that lasts 3 weeks or longer, coughing up blood, weakness or fatigue, weight loss, no appetite, chills, or fever?" Guy can't recall him coughing up blood but decides to go right to the Health Department to get a TB test, just in case.
Nurse, trying to calm Guy says, "Unless your restaurant server was physically, and in most cases visibly sick, I wouldn't worry too much about it. Wash your hands with soap and water. Cover your cough and ask those around you to do the same. The most important, and what should be the most obvious suggestion, DO NOT TOUCH SOMEONE ELSE'S BODILY FLUIDS."
With his new found knowledge and understanding of TB, Guy goes back to the local bar for lunch the next day and asks the server, just to be sure, "How you feeling?"
Posted: Saturday, April 14, 2012
Article comment by:
I can remember, as a little girl, my daddy had TB. I can remember going to the Veterans Hospital, N. Calif and sitting on the lawn and daddy standing about the 3rd floor window and us 'talking' and visiting. Of course I dont remember how long he was gone, but he came home. I remember growing up and my dad being very festidiuos.... he washed & showered and shaved every day, and only then were we allowed to give a quick peck on his cheek. As a grown up w/kids, I remember one time, my sis and my kids had positive TB tests and she and I had to go in and get tests done. The TB cells were dormant, and they asked us to take some pills for about a yr. We never had to take a TB test again, because we would always show a 'positive' even though the cell was dormant. My sis is gone now, but I am in my 60's and no TB. just sharing my memory of TB.
Posted: Thursday, April 12, 2012
Article comment by:
Historical note on Tuberculosis, especially Pulmonary Tuberculosis was a common condition of Spanish American War Veterans. Bucky O’Neil and the Rough Riders memorial reminds us of the many local veterans of the Spanish American War. Not to be scoffed at were the Regular 1st US Cavalry, who my Grandfather “William W Bishop” of C troop served a full 3 years. Many of these troops fought alongside each other, at the battle of Las Guasimas and San Juan Hill. The toll taken on these solders was horrific and should be appreciated.