The different faces of tuberculosis: A silent disease

(BPT) - Picture coming home from traveling the world for six months to find out the cough you couldn’t kick was active tuberculosis (TB). Or imagine finding out your senior year of high school that you’ve been carrying around latent TB for most of your life, which progressed to active TB, infecting your friends, family and classmates. For two people — Kristen and Zee — these stories were a reality.

Approximately one-third of the world, including an estimated 13 million people in the U.S., have latent TB, which has no symptoms and can progress to active TB when a person’s immunity becomes compromised. While many people consider TB a disease of the past, it remains the leading infectious disease killer worldwide and is estimated to take a life every 18 seconds.

Tuberculosis treatment impacted Kristen and Zee’s lives for nearly a year. But had they been properly tested for, and diagnosed with, latent TB, both could have undergone treatment to stop the infection from progressing to active TB, and from spreading to others.

An unexpected senior year

After a knee injury during his senior year of high school, Zee P. had what he thought was a cold that stuck around for longer than normal.

“I was constantly tired, had lost nearly 20 pounds and couldn’t shake a deep, phlegmy cough. My doctors thought I had a cold, then pneumonia, but none of the medicine made me feel better,” recalls Zee.

After nearly a month of not knowing what was wrong, Zee was finally diagnosed with active TB. He soon learned he had been carrying around the TB bacteria in his body for more than 10 years, since his birth mother lost her battle to TB in Ethiopia when he was 7 years old. Although Zee was tested with a TB skin test when he first came to the U.S., it did not pick up the TB infection and showed a false negative so his latent TB was never treated.

“My diagnosis caused chaos throughout my community. A lot of people didn’t know what latent TB was and weren’t aware that TB is still prevalent, even here in the U.S. If doctors had tested me when I first came to America with a simple blood test, I could have avoided all of the craziness that took over my life.”

Zee began an aggressive seven-month treatment, including two months of complete quarantine. Since he had walked around with active disease for several weeks, his entire school and family were required to get tested for latent TB. They were administered a simple blood test called QuantiFERON-TB Gold, developed by QIAGEN. Fifty students, as well as his parents, tested positive for latent TB and received medication to prevent the progression to active disease.

An unwanted souvenir

San Francisco-based product marketing manager Kristen V. returned home from a trip around the globe with a chest rattle that kept waking her up at night, but her doctors couldn’t figure out the cause.

“Doctor visit after doctor visit I kept getting sent home with different allergy medications or new cough remedies, but nothing was helping. I felt like a crazy person — I started taking pictures and documenting all of my symptoms so I would have proof for my doctors because they didn’t believe something was actually wrong,” said Kristen. After months of uncertainty, Kristen was diagnosed with active TB.

An avid and educated traveler, Kristen was shocked to learn TB was so prevalent in the countries she visited, how easy it was to contract, and mainly, why she hadn’t been warned of the risk before.

“My husband and I always check the CDC website before we travel, get every vaccination needed and I have never read anything about getting tested for latent TB after traveling to these areas.” Kristen explains.

Kristen’s treatment was nine months, starting with two months of quarantine. She wasn’t allowed to go to work, go to the grocery store, or travel, and her coworkers, friends and family had to get tested for TB, too. Using the modern blood test, her husband tested positive for latent TB and was able to undergo a fairly simple treatment regimen to destroy the mycobacterium tuberculosis in his body. However, the real difference between their treatments was that he was able to continue to live a normal life, going to work, running errands and more, while her life was full of daily visits to the doctor and extreme fatigue.

“It would have been such an easy thing if I had only known to get tested when I came back home. I could have carried on with my life with a minor inconvenience of treating the latent disease, instead of having my world flipped upside down for nearly a year.”

Understanding your risk and taking action

Like Zee and Kristen, many people don’t realize they’ve been walking around with latent TB until it progresses to active disease.

Certain people are at high risk of being infected with latent TB, including immigrants from high-incidence countries, those traveling to high-incidence countries, those who have medical conditions that weaken the immune system or people on immunosuppressive medications.

If you think you or a loved one are at risk, talk to your doctor about getting tested with a blood test such as QuantiFERON-TB Gold. Learn more at www.QuantiFERON.com.

The performance of the USA format of the QuantiFERON- TB Gold test has not been extensively evaluated with specimens from individuals younger than age 17 years, or in the immunocompromised population or in patients receiving immunosuppressive treatment or drugs.

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