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TB Resurgence Sparks Concern: US Sees Alarming Rise in Cases

TB Resurgence Sparks Concern

United States: The prevalence of tuberculosis (TB) in the United States has been experiencing a resurgence after a thirty-year decline, as detailed in a recent report by the Centers for Disease Control and Prevention. This concerning trend is alarming considering the staggering 1.5 million fatalities attributed to TB annually, rendering it the most formidable infectious agent globally.

Dr. Priya Shete, an esteemed medical professor and co-director at the University of California, San Francisco Center for Tuberculosis, underscores the profound repercussions of TB beyond mortality, emphasizing the substantial burden of prolonged hospitalization and enduring health complications for survivors, according to the reports by National Geographic.

Nationwide, the year 2023 witnessed the highest recorded TB cases in the past decade. Contrary to assumptions of novel transmissions, the majority of recent cases manifest as the sudden reactivation of latent infections that had either gone unnoticed or been inadequately treated.

TB has its impact on thousands within the nation and millions across the globe while Dr Philip LoBue, head of CDC’s Division of Tuberculosis Elimination, affirms that the threat of TB to the population of the US is still low compared to India, China, and Philippines that are experiencing greater TB rates. However, the seemingly recent spike in cases has raised questions and concerns among specialists in infectious diseases and public health.

Tuberculosis is a highly contagious disease that is caused by the bacteria Mycobacterium tuberculosis, but why is this particular disease considered extremely dangerous? TB is an ancient pestilence that unites mankind as one of the longest and most lethal endemic diseases, with such ominous nicknames as the “white plague,” “consumption,” and the “robber of the youth. ” Yahalom, 150 years ago, TB preordained approximately 80% of the inflicted to die.

There is light at the end of the tunnel because through administering vaccines, accurate diagnosing tools, and antibiotic remedies, TB has been registering a steady decline in the US and across the globe.

TB is a bacterial infection that is primarily respiratory and can spread easily from one person to another; it is capable of causing harm to several organs in the body such as the renal, cardiac, bones, joint and vascular systems. Its approximate capability of transmission results to the severe consequences as meningitis, encephalitis or hepatitis according to National Geographic.

They can be transmitted from a person affected by the virus to another healthy person who comes into contact with the virus for a long time via an aerosol droplet produced through respiration, especially during coughing or sneezing. In other cases, an infected person or animal may not develop a clinical illness or may not show symptoms for a prolonged period, sometimes referred to as a ‘subclinical’ or ‘chronic’ phase of the disease before the infected animal can again become contagious.

Despite the availability and use of effective diagnostic tools and therapeutic antibiotics, TB, like other chronic illnesses, requires a long duration of treatment, often for over six months, which is likely to be fraught with compliance issues.

Arguing with Dr. Jeffrey Cox, an immunology and pathogenesis expert at University of California, Berkeley, one should mention that, On the one hand, it is crucial to stay alarmed and stop the development of TB, On the other hand, the indications warrant it to remain inactive. The failure to take measures to prevent bacterial build-up is the likely cause of a return of bacteria.

While preventable and treatable, TB persists as a formidable global threat, claiming over a million lives annually and afflicting individuals across all demographics, albeit disproportionately affecting low- and middle-income populations.

Why is there an upsurge in TB cases in the US?

Starting with a TB count of 2.09 billion in 2020, the number of TB patients has gone up by 2 percent, which is not entirely a cause for alarm for public health. The introduction of the pandemic supercharged the use of resources across the world to fight the virus, which, in essence, left Communicable diseases like TB being reported less.

As stated by Dr Cox consequently, a number of nations reported a further decline in TB cases between 2019 and 2020, nonetheless, this wasn’t indicative of a decline in TB burden. Contrarily, awareness on COVID-19 may have led to the overlooking of TB or help contribute to the spread of the disease.

According to Dr. Shete, the global pandemic saw several procedures and activities related to less critical health services be delayed and included TB preventive measures, and this convergence resulted in an upsurge in TB illnesses. Also, the people of South Africa compromised on measures such as the use of masks and enhanced mobility to boost the economy, subsequently worsening the existing Tuberculosis situation.

Modern TB patients are sicker at the time of diagnosis compared to the past, sometimes because of failed initial diagnosis or delay in diagnosis that has been propelled by the pandemic. This is one opinion that is similar to Dr. LoBue’s, pointing to the fact that pulmonary TB cases declined and then increased due to the symptoms of the disease being similar to those of COVID-19 and mobility restrictions that affected the population.

Similarly to earlier tendencies, the majority of recent TB cases originate from the relapse of previously acquired latent infections, more prevalent in immunocompromised patients like those with HIV or other immune deficiency statuses or those who operate immunosuppressive therapies.

Tuberculosis is still one of the biggest killers globally for most of what we can ask ourselves, as the following information will illustrate who is being burdened by this disease.

High-risk groups in the US include people who originate from TB-endemic countries, persons who tend to frequent those TB-endemic regions, those who live in occupations or working conditions that facilitate TB epidemics, or individuals who have a suppressed immune system. According to Dr Shete, the unequal distribution of TB cases is predominantly linked to poverty and economic inequality since TB patients are unable to afford the necessary medical care and live in appalling conditions.

TB infection rates are even higher among the historically disenfranchised populations, including Blacks and Hispanics, as presented in the new CDC report on TB in the US-born population. In any case, according to Dr Cox, national TB statistics fail to compare with global rates, and the probability of a further rise in the rate of TB in the US will only be known in future statistics.

What are the broader implications of the escalating TB rates?

Experts advocate for heightened awareness of TB without unduly alarming the public. Dr Shete stresses the preventability, diagnosability, and treatability of TB, assuring that those outside high-risk groups need not be overly concerned unless symptomatic or exposed to active infections.

However, Dr Shete underscores the importance of maintaining vigilance and implementing proactive screening measures, particularly among high-risk demographics.

She advocates for the inclusion of TB prevention strategies in Medicare coverage, citing recent recommendations from the US Preventive Services Task Force, as per National Geographic.

Long-term TB management necessitates sustained investment in clinical research and the development of more efficacious diagnostic tools and treatment modalities. Dr. Cox emphasizes the critical role of governmental funding and infrastructure in supporting these initiatives.

Ultimately, while the risk of TB for US residents remains relatively low, effective containment hinges on global cooperation. The US has prioritized this through international endeavors such as USAID’s Global TB Strategy and the CDC’s Division of Global HIV & TB, underscoring the interconnectedness of health outcomes on a global scale.

As Dr Shete aptly summarizes, the reverberations of global health dynamics inevitably reverberate within US borders.

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