Rise of TB in America

[Coastie]

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Anyone have hard numbers?

I find it scary that on my ward service, 40% of the patients have active TB.

 

[southerndoc]

Anyone have hard numbers?

I find it scary that on my ward service, 40% of the patients have active TB.

40% have active TB? You must be working where all TB patients are admitted on your particular ward.

40% on other wards might have latent TB or had a PPD conversion and not have active TB, but I doubt 40% of all patients in your hospital have active TB.

 

[Coastie]

40% have active TB? You must be working where all TB patients are admitted on your particular ward.

40% on other wards might have latent TB or had a PPD conversion and not have active TB, but I doubt 40% of all patients in your hospital have active TB.

On my teams ward service, not the hospital. Maybe it's just a streak of bad luck?

 

[Blade28]

Wow that's a lot.

We have a lot of TB here as well. Something like 25% of the patients at our county hospital either have active TB, or have been exposed to it (and therefore are PPD (+) ).

 

[elwademd]

Wow that's a lot.

We have a lot of TB here as well. Something like 25% of the patients at our county hospital either have active TB, or have been exposed to it (and therefore are PPD (+) ).

yea, grady has an insane amount. if i remember right, at least when i was in med school there, grady had more cases of tb annually then about 40 states!

 

[Blade28]

yea, grady has an insane amount. if i remember right, at least when i was in med school there, grady had more cases of tb annually then about 40 states!

Yup, we learned the same thing during orientation!

That, and 33% of patients had either hep B, hep C or HIV (or some combination of the three!). 😱

 

[gutonc]

On my teams ward service, not the hospital. Maybe it's just a streak of bad luck?

On my sub-I month at a NYC city hospital, one particular call we admitted 6 active TB cases in a day of 12 admissions. A fluke sure, but kind of freaky. Strangely enough, 2y later I'm still PPD negative...probably anergic.

 

[carrigallen]

It is possible we may be over-diagnosing it, or diagnosing it more frequently now than before. A rise in reported cases does not mean the true incidence has increased. The reporting methods or reporting criteria may have changed.

 

[Coastie]

Rise in HIV and increased immigration (without screening) are two big factors, for sure.

It is possible we may be over-diagnosing it, or diagnosing it more frequently now than before. A rise in reported cases does not mean the true incidence has increased. The reporting methods or reporting criteria may have changed.

 

[predodoc]

comming into med school I found out I was PPD +. Which was weird since about the only possible way I could have picked it up was my grandparents Nursing home that I visted probably 10 time over 3 yrs.

The Weird part is that my family also decided to get tested and my Mom, brother, and sister (everyone but my dad) had a +ppd. Anyone heard of some kind of Genetic link of having false + PPDs?

 

[PeepshowJohnny]

It is possible we may be over-diagnosing it, or diagnosing it more frequently now than before. A rise in reported cases does not mean the true incidence has increased. The reporting methods or reporting criteria may have changed.

Well, we may be picking up more cases if screening has picked up, but I think it's got more to do with immigration and HIV as others have pointed out.

That said, is anyone's institution using the interferon based TB "blood" test? Supposed to get rid of false positives from BCG vaccination, reactors from previous PPDs, and from Non-TB Mycobacterium.