The number of people in the U.S. diagnosed with TB disease is at an all-time low (11,181 total cases were reported in 2010); however, approximately 4 percent of the U.S. population, or 11 million people, are infected with the TB bacterium. TB continues to disproportionately affect racial/ethnic minorities and foreign-born individuals in the U.S.
“TB” (tuberculosis) is a disease caused by a bacterium called Mycobacterium tuberculosis which usually attack the lungs, but the TB bacteria can attack any part of the body such as the kidney, spine, and brain, and if not treated properly it can be fatal.
TB is spread through the air from one person to another. The TB bacteria are put into the air when a person with active TB disease of the lungs or throat coughs, sneezes, speaks, or sings. People nearby may breathe in these bacteria and become infected. TB cannot be spread by shaking someone’s hand, sharing food or drink, touching bed linens or toilet seats, sharing toothbrushes, or by kissing.
Not everyone infected with the TB bacteria becomes sick. The TB bacteria can live in your body without making you sick, which is called “latent TB infection” (“LTBI”). Most people who breathe in the TB bacteria and become infected are able to respond to the TB bacteria so that the bacteria do not multiply, they do not feel sick, and they do not have any symptoms. The only sign of TB infection is a positive reaction to either the tuberculin skin test or to specific blood testing for TB infection. Fortunately, people with LTBI are not infectious and cannot spread TB bacteria to others. However, if TB bacteria become active in the body and multiply, the person will get sick with “TB disease”.
TB disease occurs when the TB bacteria become active if the immune system can’t stop them from multiplying. TB disease will make people sick and they may spread the bacteria to people they spend time with every day. Many people who have latent TB infection never develop TB disease but some people develop TB disease soon after becoming infected (within weeks) before their immune system can fight the TB bacteria. Other people may get sick years later, when their immune system becomes weak for another reason. The risk for developing TB disease is higher for people who have compromised immune systems.
Recent Advances In Treatment of LTBI
Results from one of the largest U.S. government clinical trials on tuberculosis preventive therapy to date suggest that treatment for LTBI may soon be easier than ever before in countries with low-to-medium incidence of TB. The trial results showed that a supervised once-weekly regimen of rifapentine and isoniazid taken for three months was just as effective as the standard self-administered nine-month daily regimen of isoniazid, and was completed by more participants. The new regimen to treat latent TB infection reduces the doses required for treatment from 270 daily doses to 12 once-weekly doses, making it much easier for patients to take.
The new regimen was found to be safe and as effective as the standard regimen in preventing new cases of TB disease, with very few cases of TB disease developing in either the standard regimen or the new regimen study participants. Seven cases occurred among those receiving the new treatment regimen compared to 15 among those receiving the standard treatment. The percentage of participants completing the new, shorter regimen was substantially higher (82%) than the percentage completing the standard regimen (69%).
The study lasted approximately 10 years and included 8,053 participants over the age of 2 who lived in countries with low or medium TB incidence, with the majority from the United States or Canada.
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