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How Serious Is Tuberculosis?
Without a correct diagnosis and treatment, tuberculosis can sometimes be a serious, potentially life threatening infection. However, with the right steps, it is curable.
Tuberculosis (TB) is a potentially serious bacterial infection that can affect your lungs and other parts of your body. It's spread through droplets when someone with TB talks, coughs, or sneezes.
TB can be asymptomatic, so it's possible to have the infection and not even know it. In some cases, TB mimics mild, cold-like symptoms, which can delay or prevent people from seeking care.
Even though TB is curable, without a correct diagnosis and treatment, TB can progress to a more serious, life threatening infection.
Here's what to know to protect your health.
With active TB, the bacteria multiply and attack the body. TB infection primarily affects the lungs but can also spread to other parts of the body, such as:
When active TB spreads, it increases your risk of additional health problems and can even be life threatening. Certain people, including babies or young children and those with a compromised immune system, have a higher risk of developing active TB than the general population.
A 2014 study found that, even after successful TB treatment, people who had the infection lost an average of 3.6 years of life expectancy compared to those who never had TB. Findings from a 2020 study note that, without treatment, TB can take an average of 7 years off of average life expectancy.
Even though TB can reduce longevity, treatment saves lives. Experts credit current treatments with saving over 53 million lives worldwide since 2000. And most people who develop TB go on to live a regular life.
With prompt diagnosis and treatment, the vast majority of TB cases are curable.
Latent TB can be asymptomatic but still requires treatment. A doctor can prescribe antibiotics to help clear the bacteria from your body and prevent it from developing into active TB. You'll need to take medication as prescribed for 6–9 months.
Active TB is also treated with antibiotics. You'll typically need a combination of antibiotics to clear the infection from your body. You'll also need to continue treatment for 6–12 months.
Take any prescribed TB medications exactly as directed. Be sure to complete the entire course, even if you feel fine. Skipping or missing a dose can result in the infection becoming resistant to the medication, making it much harder to treat.
Get the answers to some of the most common questions about TB.
How long does it take to cure tuberculosis?TB is curable, but treatment takes time. That's because TB germs take a long time to clear the body.
Treatment for latent TB may take up to 9 months to complete. Treatment for active TB can take up to 12 months to fully clear the infection.
You need to take medications exactly as prescribed for months at a time, even if you start to feel better quickly. This helps your body clear the infection entirely from your body and prevents it from becoming resistant to treatment.
Can I survive tuberculosis without treatment?Not everyone who develops TB feels sick. However, without the correct treatment, TB can become life threatening for up to two-thirds of people who develop the infection.
Even if you have latent TB, getting treated can prevent it from progressing to active TB and posing serious risks to your health.
Can you get tuberculosis a second time?It is possible to develop TB more than once. Even if you've been cured of TB, you can contract the bacteria again.
Researchers are unclear whether a recurring infection is a relapse of the original TB bacteria or reinfection with a new strain.
If you think you've developed a case of recurring TB, contact a doctor to discuss next steps.
For some, TB can be a serious, potentially life threatening bacterial infection. However, TB is also treatable. Prompt diagnosis and treatment can cure a TB infection.
Talk with a doctor right away if you suspect you may have been exposed to TB. Taking action can help prevent an exposure from developing into active TB and protect your health.
Tuberculosis At The Border: Doctors Issue Warnings Of 'drug-resistant Strains'
Cases of tuberculosis (TB) — an illness that kills more people than any other infectious disease — rose in the U.S. During 2022, per the Centers for Disease Control and Prevention (CDC). And some doctors are concerned that limitations of testing at the border could be partly to blame for the surge.
In 2021, the disease infected nearly 11 million people and caused 1.6 million deaths worldwide, according to the World Health Organization (WHO).
Tuberculosis is a highly contagious disease caused by a bacterial infection. It primarily affects the lungs, but can also affect the brain, kidneys and spine.
Required testing may have limitations: CDCThe CDC states that all refugees ages two and older must be tested for tuberculosis before entering the U.S.
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"By law, refugees diagnosed with an inadmissible condition are not permitted to depart for the United States until the condition has been treated," the agency states on its website.
Some doctors are concerned that limitations of testing at the border could be partly to blame for the rise in tuberculosis cases. (iStock)
The CDC uses its Electronic Disease Notification (EDN) system to notify federal, state and local health departments of any immigrants and refugees who are found to have medical conditions that require follow-up.
There are limitations to that process, however.
"By design, the EDN system only collects information for the approximately 10% of immigrants who have an overseas medical classification," explained Neha Sood, health communication specialist for the CDC in Atlanta, Georgia, in a statement to Dr. Marc Siegel, clinical professor of medicine at NYU Langone Medical Center and a Fox News medical contributor.
"Human error likely caused some losses, resulting in possible underestimates of immigrants with medical classifications."
"Thus, DHS [Department of Homeland Security] data were used to approximate the immigrant denominators."
There is also some degree of human error that comes into play, Sood added.
"Because data transfer for immigrants during the study period primarily relied on staff at ports of entry to correctly review, retain and route paper forms for each immigrant with a medical classification, human error likely caused some losses, resulting in possible underestimates of immigrants with medical classifications," she said.
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While health departments are "encouraged and provided incentives" to share the results of immigrants' testing with the CDC, Sood said there is always the chance of "underreporting."
She added, "The proportion of immigrants, refugees and eligible others who completed a post-arrival examination might be higher than indicated in this report."
Although the CDC has "comprehensive surveillance systems" to track communicable diseases within the U.S., the agency does not track diseases by immigration status, Sood explained.
Tuberculosis is a highly contagious disease that primarily affects the lungs, but can also affect the brain, kidneys and spine. (Spencer Platt/Getty Images)
Linda Yancey, M.D., a specialist in infectious disease who is affiliated with Memorial Hermann Health System in Houston, Texas, said she regularly sees people who have screened positive for the disease and need treatment to prevent developing symptomatic illness.
"Tuberculosis is quite common in Texas, especially in the big cities," she told Fox News Digital. "Houston is an international port of entry, so we get people from TB-endemic areas coming here frequently."
Most of the imported tuberculosis cases seen at Memorial Hermann are among people coming from Africa and the Indian subcontinent, Yancey said.
"People can be exposed to TB years before they become contagious."
"This is why immigrants coming into the U.S. Are screened at the time of entry," she said.
"People can be exposed to TB years before they become contagious," she went on. "By doing early screening, we are able to treat people long before they develop severe pneumonia."
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Immigrants who have positive screenings are given three to four months of pills to protect their TB from developing into an illness, Yancey said.
In a 2022 study by the University of Texas, researchers analyzed patterns in tuberculosis patients who had been diagnosed when crossing into the U.S. From the Mexican state of Tamaulipas, which serves as a "migration waypoint."
A diagnosis of tuberculosis can be made via a skin test or a blood test. (iStock)
The study, which was published in the Journal of Immigrant and Minority Health, found that an average of 30% of immigrants screened positive for tuberculosis over an eight-year period.
Immigrants with tuberculosis may be less likely to get successful treatment due to various factors, the study authors also wrote in a discussion of their findings.
The barriers to treatment that were cited included mobile living conditions, economic constraints, fear of deportation and the policy of the host country to provide free TB therapies.
Drug-resistant tuberculosis poses treatment challengeAnother concern is the type of TB that potentially could be coming into the U.S.
James Hodges, M.D., an internist in Waco, Texas, is concerned that immigrants are bringing in a drug-resistant strain of the disease.
"Immigrants who are positive for tuberculosis are more likely to have a drug-resistant type."
"I have found that immigrants who are positive for TB are more likely to have a drug-resistant type," he told Siegel.
"This is likely due to the over-the-counter meds and antibiotics that are available in Mexico and other central and South American countries — these patients have incompletely treated coughs on their own," Hodges continued.
"This is becoming more common with the last two years of an open border," Dr. Hodges of Waco, Texas, said of drug-resistant tuberculosis cases entering the United States of America. (iStock)
"This is becoming more common with the last two years of an open border."
Tuberculosis treatments need to be "specialized, complex regimens," Dr. Siegel explained. "Here in the U.S., we use INH, Rifampin, PZA, Ethambutol and others. If you use an over-the-counter antibiotic that only partially treats TB, resistance is more likely to emerge."
Facts about tuberculosis symptoms, diagnosis and treatmentExposure to tuberculosis is very common, but only about 20% to 30% of people who are exposed to it become infected, according to Mount Sinai.
Most new infections occur when bacteria enter the air after the infected person coughs or sneezes, and is then breathed in by someone else.
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A majority of people who get the infection will have no symptoms and are not contagious, which is known as "latent tuberculosis."
Those who have "active infections" develop the disease, experience symptoms and can potentially spread it to others.
During the first stage of TB, most people don't experience any symptoms, though some may have a mild fever, cough and/or fatigue.
During the first stage of TB, most people don't experience any symptoms, but some may have a mild fever, cough and/or fatigue. (iStock)
Patients who develop an active infection — either immediately after the primary infection or after months or years of a latent infection — may experience coughing (sometimes with blood or mucus), chest pain, pain when breathing or coughing, fever, chills, weight loss, night sweats, loss of appetite and/or fatigue, according to the Mayo Clinic's website.
Some people may develop extrapulmonary tuberculosis, which is when the infection spreads from the lungs to affect other parts of the body.
"If you have tuberculosis and you're treated, your outlook is good if you've followed directions and taken your medications for as long as you should and in the way you were told."
There is currently no vaccine for TB available in the U.S.
Diagnosis can be made via a skin test or a blood test.
For those who have positive screenings, additional tests — including chest X-rays, CT scans and lab analysis of lung fluid — can determine the extent of the infection and the impact on the lungs, according to the Cleveland Clinic website.
For those who have positive screenings, additional tests — including chest X-rays, CT scans and lab analysis of lung fluid — can determine the extent of the infection and the impact on the lungs. (iStock)
There are multiple treatments available for both latent and active tuberculosis, Yancey said.
"For latent disease, we treat with drugs like rifampin, rifapentine and isoniazid," she said. "People only need to take the pills for three to four months."
For active disease, additional pill options include pyrazinamide, ethambutol, moxifloxicin and linezolid, Yancey said.
There is also an injectable option called amikacin.
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"Because we have so many different options to treat TB, drug shortages are very seldom an issue," Yancey said. "If one drug is in short supply, we have multiple effective alternative regimens."
Medications are typically taken for a period of at least six to nine months.
If left untreated, the disease can be fatal.
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"If you have tuberculosis and you're treated, your outlook is good if you've followed directions and taken your medications for as long as you should and in the way you were told," the Cleveland Clinic's website indicates.
People who experience chest pain, severe headache, seizures, confusion, difficulty breathing, bloody mucus or blood in the urine or stool should seek emergency medical care right away, per the Mayo Clinic.
Melissa Rudy is health editor and a member of the lifestyle team at Fox News Digital.
Millions Could Soon Have Access To Lifesaving Tuberculosis Drug Following Online Uproar
In a move welcomed by advocates, a treatment for multi-drug resistant tuberculosis could soon become more accessible for millions of people worldwide.
Although tuberculosis is uncommon in the U.S., it is the top infectious disease killer worldwide after COVID-19, claiming an estimated 1.6 million lives in 2021, according to the World Health Organization.
A lifesaving drug called bedaquiline, when used along with other medications, works to kill the bacteria that causes multi-drug resistant tuberculosis (MDR-TB). While the drug's primary patent was set to expire this week, allowing less-expensive generic versions to be manufactured and distributed, Johnson & Johnson, which makes and markets bedaquiline under the brand name Sirturo, had planned to utilize a secondary patent to extend their control of it until the end of 2027, advocates say.
In a now-viral YouTube video, author and advocate John Green protested Johnson & Johnson's patent extension on bedaquiline and rallied his 4.5 million Twitter followers to pressure the company to change course.
Amid the Twitter uproar, Stop TB Partnership – a United Nations-hosted organization that works to address tuberculosis worldwide – announced a partnership with the pharma giant to "tender, procure, and supply generic versions of SIRTURO® (bedaquiline) for the majority of low- and middle-income countries, including countries where patents remain in effect."
Researchers have estimated prices of generic versions of bedaquiline could be up to 94% lower than current costs, with large-scale manufacturing.
The availability of the generic drug could provide six million people with treatment over the next four years, according to Carole Mitnick, Sc.D., a professor of global health and social medicine at Harvard Medical School and a senior research associate at Partners in Health.
While advocates celebrated the news, Johnson & Johnson said the partnership was already in the works prior to the media uproar and that it was "false to suggest" that patents were being used to prevent broader access to bedaquiline.
"We've been in lengthy discussions with the Global Drug Facility regarding access to bedaquiline. We had our first meeting with them at the beginning of this year and reached an agreement on June 13," a Johnson & Johnson spokesperson told ABC News via email.
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Pharmaceutical companies often file for patent extensions on their drugs to prevent market competition, a strategy called "evergreening." However, advocates say this system hinders access to affordable medicines globally, sometimes for many years after a drug is first launched.
"Patents are supposed to last for a limited period of time. After that, competitors should enter the market to drive prices down. But that's not what's happening," said Robin Feldman, professor of law at University of California Law San Francisco. "Instead, drug companies pile new protections onto their drug to extend that protection."
Patents serve a key role, however, by incentivizing innovation. "Companies fund an extraordinary amount in researching and producing and we want to encourage companies to engage in that research. The patent is a reward for that successful research," Feldman added.
But Feldman's research shows that here in the U.S., an estimated 78% of drugs with new patents in the Food and Drug Administration's records were evergreening extensions for existing drugs.
John Green, who created the YouTube video addressing the bedaquiline issue, told ABC News he was first exposed to the devastation of tuberculosis during a trip to Sierra Leone.
"When I was there, I met a young man who looked to be my son's age, who looked 9 at the time but was in fact 16 and was just really emaciated, stunted by really severe multi-drug resistant tuberculosis," said Green.
"Then when I got home, I started to wonder why I didn't know more about this disease that kills more people than HIV. Kills more people than malaria and war and cholera combined, every year," he added.
"Despite causing millions of deaths each year and the avail of treatment and vaccines, tuberculosis remains a largely ignored global health issue," said John Brownstein, Ph.D., ABC News contributor and chief innovation officer at Boston Children's Hospital.
The disease is much rarer in the U.S. Compared to other countries. There were an estimated 8,300 reported cases of tuberculosis in 2022, with rates steadily declining since the early 1990s, according to the Centers for Disease Control and Prevention.
A vaccine exists to protect against tuberculosis and is typically given to young children in countries where the disease is more common. But the vaccine does not always fully protect against infection.
"[Tuberculosis] disproportionately affects people who are most impoverished and most marginalized. It is highly stigmatized and has a lot of overlap with important chronic diseases like HIV and diabetes," Harvard Medical School's Carole Mitnick said.
Tuberculosis is curable with antibiotics. However, people in lower-income countries have a higher risk of developing an infection that is resistant to multiple medications.
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Nearly 500,000 new cases of MDR-TB occur each year and only about one in three people with the disease accessed treatment in 2021, according to the World Health Organization. Those infection numbers have been trending upward, which scientists attribute to the impact of the COVID-19 pandemic.
Advocacy groups like Doctors Without Borders and Partners in Health, who for years have been pushing for greater access to tuberculosis medications, called for more action to ensure patients have better access to them.
"We reiterate our call on [Johnson & Johnson] to publicly announce it will not enforce any secondary patents on bedaquiline in any country with a high burden of TB, and withdraw and abandon all pending secondary patent applications for this lifesaving drug," Doctors Without Borders said in a press release.
In answer to an ABC News request to respond to the Doctors Without Borders statement, Johnson & Johnson said, in part, that it was "deeply committed to patient needs around the world, particularly in providing access to innovation for the most vulnerable populations in low- and middle-income countries," and highlighted what it said were the company's "broad access efforts" in providing bedaquiline to those who need it.
"This includes entering into a collaboration in June this year with the Stop TB Partnership's Global Drug Facility ("GDF") – the largest procurer of TB medicines – which enables them to invite potential generic suppliers and purchase generic versions of SIRTURO® 100mg," the statement further declared.
The Johnson & Johnson statement did not specifically address bedaquiline patents and patent applications.
"I think it's a profoundly unacceptable injustice," Green said of the overall bedaquiline access issue. "And we need to react appropriately. And to see that over the last few days has been extremely encouraging to me."
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