Sunday 21 February 2016

Tuberculosis Is Coming Back – Here’s Why

Tuberculosis is a disease caused by bacteria that infects the lungs. It is highly contagious and can potentially be fatal, but until recently it was on the way out.

A special report by Megan Ray Nichols.

During the last 20 years, overuse of antibiotics has helped to create drug-resistant strains of the bacterium that have turned tuberculosis from a Victorian-era disease that was often romanticized into something that needs to be feared and respected once again.

Concentration in Cases

While the overall number of tuberculosis cases in the U.S. is dropping, a number of population subsets are increasingly affected by the disease.

A number of factors put individuals at risk for contracting TB, including weakened immune systems or medical professionals pass on the infection after treating infected patients. A 2014 report by the CDC revealed some worrisome trends, including the fact that more than 50 percent of TB cases are concentrated in four states: Florida, New York, Texas and Florida.

What do those four states have in common? They are also the main entry points for immigrants, both legal and illegal, who are entering the United States. As of 2013, more than 64 percent of TB cases were diagnosed in foreign-born individuals who had come to the United States.

Since a standard case of TB often costs around $17,000 to treat, many people who don’t have access to health care or insurance often go untreated, spreading the disease to anyone that they may come into contact with. Drug-resistant TB can cost even more, with a full treatment reaching $134,000. Extreme drug-resistant TB, which doesn’t respond to any of the traditional treatments, can cost nearly half a million dollars and even this cost doesn’t guarantee that the patient will be cured of the disease.

What Has Been Done?

TB causes more deaths globally than any other infectious diseases. It is airborne and released when an infected patient coughs or sneezes, and can easily be caught by anyone who is in close proximity to the infected individual.

The current immigration polices both in the U.S. and in areas like London do not allow for the screening and/or treatment of potentially infected individuals. Instead, large numbers of these individuals are living together, often in small or substandard housing which creates the perfect transmission conditions for TB and other similar diseases.

The Centers for Disease Control have guidelines in place requiring medical examinations for any refugees or immigrants coming into the United States, whether they are here on a temporary visa or permanently. Unfortunately, they can only perform these exams if the individuals are entering the country legally. Individuals who carry TB and other similar diseases but are not able to be examined are carrying a disease that was nearly eradicated in many countries into fresh breeding grounds.

What Precautions Need to be Taken?

While there is a great call right now for countries to open their borders in the wake of the events in Syria that left many as refugees, the borders should be opened intelligently.

  • Housing needs to be improved for refugees or immigrants so that large numbers of people are not crammed into small spaces.
  • Individuals need to submit to a medical exam before being allowed to enter a country. A basic TB test usually takes less than 24 hours if the patient isn’t symptomatic. 
  • Medical establishments need to be more approachable — if an individual is presenting symptoms of TB, they should be able to approach a medical establishment for treatment, if for no other reason than to prevent the disease from spreading farther. 
  • The public as a whole, including refugees and immigrants, needs to be educated on the symptoms and effects of the disease. Someone might go about their day just thinking they have a bad cough while transmitting TB to everyone they meet.
These precautions might seem a bit harsh, but with many people crossing borders into countries where TB was nearly a thing of the past, heavy-handed precautionary measures may be just the thing to help us wipe out TB once and for all.

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