Tuberculosis testing for those at risk

DEAR DR. ROACH: I am a nursing student in my 30s and originally from the Philippines. As part of my testing, I had a skin test for tuberculosis, which was positive. I had a friend in the hospital with tuberculosis. My doctor has recommended that I get treated for latent tuberculosis. What does this mean? — A.C.S.

ANSWER: Most people who are exposed to tuberculosis will not develop the disease. Some people will develop “latent” infection. This means there is active tuberculosis bacteria in their body, but their system is keeping it from becoming a full-blown infection.

People in this situation are at risk of the latent tuberculosis escaping the immune system and developing into tuberculosis. Treatment of the latent tuberculosis is intended to reduce the risk of this happening.

Testing is recommended only for people who are likely to be treated. You have two reasons to be tested: First, as a health care worker — congratulations on becoming a nurse, we need you! — you are at risk of acquiring tuberculosis infection and should be screened. Second, people born in the Philippines are at risk for having acquired tuberculosis, often in childhood.

People in their 30s are generally at very low risk of serious side effects from the medications used to treat latent tuberculosis infection. Isoniazid (INH) and rifampin are the medicines commonly used. Since the risk of developing disease later in life is much higher than the risk of a serious side effect, treatment is recommended in your case.

(Roach is a columnist for the North American Press Syndicate. Write to him at 628 Virginia Drive, Orlando, FL 32803.)


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