Tuesday, March 24 is World TB Day. This annual event commemorates the date in 1882 when Dr. Robert Koch announced his discovery of Mycobacterium tuberculosis, the bacillus that causes tuberculosis (TB).
Tuberculosis, commonly known as TB, is an ancient disease. It has been documented as far back as 4000 years ago in Egypt. Historically, TB has been known as consumption, the white plague and wasting disease. Before modern medicine, TB was a death sentence. Even with our ability today to diagnose and treat TB, 1.4 million people worldwide will die each year from this disease.
One of the challenges facing the eradication of TB is the stigma attached to the disease. Unfortunately, TB has been considered a disease of poverty, chronic disease and in general, a disease of other countries. Because of changing demographics, changing migration patterns and international travel and trade, anyone can get TB.
TB is divided into 2 related conditions – Latent TB (LTBI) and TB disease. Latent TB is when TB is present but does not make the individual physically sick. Individuals infected with latent TB have no symptoms, may not even know they have TB and cannot spread the TB bacteria to others. Individuals with Latent TB can develop TB disease if they don’t receive treatment.
TB disease is active TB. Individuals with TB disease are physically sick and can spread the bacteria to others; left untreated or inadequately treated, TB disease can lead to death.
Multidrug-resistant TB (MDR TB) is caused by TB bacteria that is resistant to at least isoniazid and rifampin, the two most potent TB drugs. These drugs are used to treat all persons with TB disease.
Extensively drug-resistant TB (XDR TB) is a rare type of MDR TB that is resistant to isoniazid and rifampin, plus any fluoroquinolone and at least one of three injectable second-line drugs (i.e., amikacin, kanamycin, or capreomycin).
XDR TB is of special concern for people with HIV infection or other conditions that can weaken the immune system. These people are more likely to develop TB disease once they are infected and also have a higher risk of death once they develop TB.
World TB Day aims to educate the world about the prevalence and dangers of TB. The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC), in conjunction with other leading healthcare organizations, are leading efforts worldwide to educate people on the successes and challenges faced in combating the TB epidemic.
The theme of World TB Day 2020 is “It’s TIME” – It is time to test and treat latent TB infection. In the United States alone, up to 13 million people have latent TB infection. It is critical to public health that individuals with latent TB are diagnosed and treated appropriately to control and eliminate TB disease within the United States.
It is time to strengthen TB education and awareness among health care providers. Treatment of latent TB infections is essential to controlling and eliminating TB in the US and worldwide. With proper diagnosis, treatment and follow up care, TB can be eradicated.
In all health care settings, particularly those in which people are at high risk for exposure to TB, policies and procedures for TB control should be developed, reviewed periodically, and evaluated for effectiveness to determine the actions necessary to minimize the risk for transmission of TB.
The TB infection control program should be based on a three-level hierarchy of control measures and include:
- Administrative measures
- Environmental controls
- Use of respiratory protective equipment
On May 17, 2019, the Centers for Disease Control and Prevention (CDC) and the National Tuberculosis Controllers Association (NTCA) released updated recommendations on the frequency of TB screening, testing, and treatment for health care personnel. For guidance on facility risk assessments and infection control practices please continue to refer to the Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, 2005.