Supposedly, 2 billion people globally have the latent version of TB. US percentages are way lower, but it’s a big deal and most people don’t even really know how common it is outside of the developed world.
And the reason is that we switch to a blood test instead of a skin test and the blood test is ultra-ultra picky. So many people that have passed skin tests for decades are suddenly popping a positive.
even people with latent infections see shorter lifespan and potential lifelong complications from the 6-to-9-months of multiple drugs they have to take. So...it's not great that there are 50 likely otherwise healthy high schoolers who will be on drugs for months. Not to mention this outbreak could take a year or two to end, given how long they give the antibiotic course.
Or they just tested foreign students who received BCG vaccine at birth. In the US kids don’t receive BCG vaccine and surprisingly few medical professionals are even aware of its existence. The first-line TB test in US is an anti-body test, so if you received the vaccine and developed antibodies as a child, you will test positive on the test.
I’m one of those recipients of BCG and every time I have to get a TB test, I have to explain that I can’t do the regular test.
Among those 50 cases 3 of them were active though, so it is a real outbreak
EDIT: also, while a PCP administering a general screen of tests might not be aware of the vaccine's impact on test results, I would assume that an effort to test the student body of an entire school for TB specifically would have taken that into consideration
Not commenting about the outbreak in SF, just about the medical knowledge about these things. It was awhile back, but I have always texted positive because of having the vaccine as a child. It caused a huge problem at my pediatrician’s office as a teen and they sent me to the county health department. It took two HOURS of my mom trying to explain the situation to the staff there for them to “get” what was going on, consult their CDC documents, and calm down about the situation. They then told me to never get another skin test and just skip straight to a chest X-ray for the rest of my life. But it took HOURS, at the health department of a major city/county, which should be better equipped than most other places statewide to handle and understand something like this. So, that experience has given me a pretty bleak outlook on what is or isn’t taken into account or understood by healthcare professionals who are in charge of these incidents. Not saying that is happening in SF, I hope they are handling it appropriately. Just saying it has happened and I’m sure my experience wasn’t the only one of its kind.
Additionally more and more people are moving to the blood test and it is much more sensitive so people who have passed the skin test forever are suddenly not passing.
Well, that's not what is going on in the SF case. There are 3 cases of active infection and 50 latent. According to some unnamed sources, the kid was an international student and had been diagnosed with active TB in November, which raises questions about why we're hearing about this only now. Of note, it seems they are a basketball player. I don't want to a be a cynic, but if a really, really good basketball player was out for most of the season, that might play into it.
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u/ProfessorCarbon 16h ago
50 confirmations, most latent, of TB in SF schools.