Be aware of Tuberculosis
By Dr. Luis Suarez.
Tuberculosis, a disease that was considered under control at the end of 80´s, has re-emerged like a serious health problem around the world. It is a contagious disease. Like common cold, it spreads through the air, when people carrying the bacteria in their lungs cough, sneeze, talk or spit. It is common in third world countries, being Mexico one of the countries with risk for this disease. Every year nearly 5000 patients die in Mexico from this infection. It can be transmitted also through unpasteurized milk or milk products obtained from infected cattle. There is virtually no danger of its being spread by dishes, linens, and items that are touched by patients with tuberculosis.
When an infectious patient coughs, he propels many TB germs into the air, and a person needs only to inhale a small number of these to be infected; depending on host factors this initial infection may:
• Be eliminated,
• Remain latent - where the individual has no symptoms but the TB bacteria remain in the body, or
• Progress to active TB over the following weeks or months.
Both last conditions can be treated successfully with medications. Left untreated, each person with active TB disease will infect on average between 10 and 15 people every year.
CHEST XR from a Mexican patient, who has been loosing weight, mild fever, chronic cough and finally bloody phlegm, there is a white “spot” in the right side with a small “hole” or Tuberculosis cavern…Tuberculosis is a serious health problem in Mexico and third-world-countries…
RISK FOR TRAVELLERS OR PEOPLE LIVING ABROAD
Travellers who anticipate repeated travel with possible prolonged exposure or an extended stay over a period of years in an endemic country like Mexico, should be advised to have a skin testing and, if the reaction is negative, annual screening (some countries, Like United Kingdom, recommend BCG vaccine for traveller less than 35 year old when travelling more than one month to high risk areas). The risk of tuberculosis transmission on an airplane does not appear to be greater than in any other enclosed space.
Travellers should be advised to avoid exposure in crowded environments (e.g., hospitals, prisons, or homeless shelters). Travellers who will be working in hospitals or health-care settings where tuberculosis patients are likely to be encountered should be advised to consult infection control or occupational health experts about procedures for obtaining personal respiratory protective devices (e.g., N-95 respirators), along with appropriate fitting and training.
Persons who are infected or who become infected with M. tuberculosis should be treated to prevent progression to tuberculosis disease. Travellers who have tuberculin skin test conversion associated with international travel should consult experts in infectious diseases or pulmonary medicine.
Based on World Health Organization recommendations, the Tuberculosis (Bacille Calmette-Guérin) vaccine is used in most developing countries to reduce the severe consequences of tuberculosis (TB meningitis or miliary form of the disease) in infants and children. However, 
this vaccine has variable efficacy in preventing the adult forms. Therefore, it not routinely recommended for use in the United States.
Some symptoms of initial Tuberculosis are fatigue, weight loss, night sweats, and chronic cough. If you have more than one year living in Mexico, it is recommended that you get a Tuberculin skin test. This test gives you the chance for early detection and treatment. 
For more information about Tuberculin skin testing (Mantoux test) e-mail me to suloluis@hotmail.com
Do you want more information about Tb in the Americas? Visit The World Health Organization website http://www.who.int/topics/tuberculosis/en/ and The Pan-American Health Organization, http://www.paho.org/english/hcp/hct/tub/
tuberculosis.htm
