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How long does someone with tuberculosis live without taking any medication?
If a person has active TB or TB disease, they can spread it by coughing or sneezing in the air. They can not spread it by kissing, hugging, sharing food etc. You would contract it by inhaling the air with the bacteria after they coughed or sneezed. If your immune system can somewhat fight it, you would be diagnosed with latent tuberculosis infection. If infected with LTBI, you can't spread it. But, it can lead to active TB or TB disease. It can take anywhere from several weeks to several years for LTBI to evolve into TB disease. Either one can be diagnosed through a blood test or a Tuberculin skin test. Also, LTBI can be prevented from evolving into TB disease with the right medication.
How tuberculosis prevented?
I don't think that you can prevent this disease so to speak, the only way would be to not get exposed to it in the first place. So if you know someone that has TB avoid contact. This is partly true, and partly false. Having been exposed to tuberculosis and having inhaled tuberculosis germs, one can prevent tuberculosis; meaning tuberculosis disease, or TB by taking preventive medicine, primarily isoniazid or INH supplemented by vitamin B6. The course of treatment is typically 6 months. As the previous person commented, if you never get exposed to TB in the first place, there would be nothing to prevent. Persons that breathe in TB germs and do not have active tuberculosis disease have latent tuberculosis infection, or LTBI. The preventive meds, or INH would be prescribed to persons with LTBI in order to prevent them from developing tuberculosis disease, or TB.
How can drug resistance be avoided in case of TB?
I don't think that you can prevent this disease so to speak, the only way would be to not get exposed to it in the first place. So if you know someone that has TB avoid contact. This is partly true, and partly false. Having been exposed to tuberculosis and having inhaled tuberculosis germs, one can prevent tuberculosis; meaning tuberculosis disease, or TB by taking preventive medicine, primarily isoniazid or INH supplemented by vitamin B6. The course of treatment is typically 6 months. As the previous person commented, if you never get exposed to TB in the first place, there would be nothing to prevent. Persons that breathe in TB germs and do not have active tuberculosis disease have latent tuberculosis infection, or LTBI. The preventive meds, or INH would be prescribed to persons with LTBI in order to prevent them from developing tuberculosis disease, or TB.
Should employee health conduct a PPD skin test on an immunocompromised healthcare worker?
These are straight from the CDC. Persons receiving prolonged therapy with corticosteroids and other immunosuppressive agents may be at risk for reactivation of TB, but the exact risk is unknown (1). Because prednisone (or its equivalent) given >15 mg/d for 2--4 wk suppresses tuberculin reactivity (55,56), and because lower doses or those given intermittently are not associated with TB, this dose is likely the lower limit that could predispose persons to develop TB (57). Reactivation of TB is more likely to occur in persons receiving higher doses of corticosteroids for prolonged periods of time, especially in populations at high risk for TB, but specific thresholds of dose and duration that could increase the risk for TB are unknown For persons who are at highest risk for developing TB disease if they become infected with M. tuberculosis, a cut-off level of >5 mm is recommended. Persons who are immunosuppressed because of disease (e.g., HIV infection) or drugs (e.g., systemic corticosteroids) have a high likelihood of developing TB disease if they are infected with M. tuberculosis. Previous BCG vaccination. Intracutaneous inoculation with BCG is currently used in many parts of the world as a vaccine against tuberculosis. Tuberculin reactivity caused by BCG vaccination generally wanes with the passage of time but can be boosted by the tuberculin skin test. Periodic skin testing may prolong reactivity to tuberculin in vaccinated persons (74). No reliable method has been developed to distinguish tuberculin reactions caused by vaccination with BCG from those caused by natural mycobacterial infections, although reactions of >20 mm of induration are not likely caused by BCG (75). HIV infection and anergy testing. HIV-infected persons may have a compromised ability to react to tuberculin skin tests because of cutaneous anergy associated with progressive HIV immunosuppression (76). However, the usefulness of anergy testing in selecting tuberculin-negative, HIV-infected persons who might benefit from treatment of LTBI has not been demonstrated (77). Who Can Receive a TST?Most persons can receive a TST. TST is contraindicated only for persons who have had a severe reaction (e.g., necrosis, blistering, anaphylactic shock, or ulcerations) to a previous TST. It is not contraindicated for any other persons, including infants, children, pregnant women, persons who are HIV-infected, or persons who have been vaccinated with BCG
