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letter: you may have been exposed to Tuberculosis

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  • letter: you may have been exposed to Tuberculosis

    Hi everyone, I'm a big fan of Mark's posts and also search through the forums here from time to time. Today I'm trying to find info about something very specific and hoping I could get some advice here.

    Today I got a letter from the health department saying that I may have been in proximity with a person recently diagnosed with Tuberculosis. They have set an appointment for me to have a Mantoux test. (Mantoux test involves injecting glycerol extract of tubercle bacillus under skin and checking 2 days later for a reaction).

    My initial feeling on this is to skip the test (which I will explain) and to investigate anything I can do to boost my immune system in case I have been exposed. Not sure if it means anything now but I was vaccinated against TB about 17 years ago.

    After I got the letter I phoned the health department to see if I could find out where and when I may have been exposed. I was told that I may have been exposed at the educational institution I attend but they wouldn't tell me anything about which class or classes or when. As I haven't been on the campus in the last 2 weeks the "when" information is important to me. They did say the exposure "wouldn't have been a long time ago" - which is of course as helpful as "how long is a piece of string". I phoned the educational institution and was passed between admin, health services and 2 nurses but no one there knew anything about that specific case. I had very little contact with other students except for 4 other students I did group work with - we didn't get in each other's personal space and none of them seemed even slightly sick any of the time I worked with them. I consider the chance that I was exposed to the mystery person to be extremely low - no more so than someone they may have spoken to at the grocery store or sat next to on the bus. If exposure in these ways was a substantial risk it would have been mentioned on the evening news at some point - but it wasn't. So, I don't consider myself at any more risk than the rest of the general populous.

    Which brings me to my next point. Medicine is supposed to follow the creed "first do no harm". Every time you do a test like the Mantoux test the patient is exposed to risks - risk of infection, risk of reacting badly to a preservative in the test substance, possibly risk from the extract of tubercle bacillus itself (?). If no one can tell me that I actually WAS in close proximity to the mystery person why should I be exposed to those risks? The test doesn't even give a positive or negative result anyway. One "negative" test means nothing until there is a second one some time later that agrees - but this second test is not even being offered. The test is for "exposure" not TB and the health dept nurse told me that exposure doesn't often lead to TB and that in fact one third of the world's population have been exposed. Nothing in any of this is convincing me to submit to the risks involved with the medical procedure.

    But on the off chance that I have been "exposed" and it could lead to developing TB (assuming my vaccination is no help) I'm wondering if I should chase up something like intravenous Vitamin C therapy to give my immune system a huge boost in case there is an infection it needs to fight.

    So, I'm really wondering about others thoughts on my thoughts about getting tested. It's hard to be objective as I'm pretty upset right now that I'm not entitled to know WHEN I might have been exposed. As I was told by the nurse that it takes 10 weeks to become contagious surely its only fair to know the possible starting point! Also, I'd like to hear from anyone that knows about tuberculosis and whether there are alternative treatments to the mainstream ones offered. I guess its vaguely plausible that this could come up for me in the future so could be good to know for that reason but wondering if it could also throw light on some possible preventative measures I could employ right now.

  • #2
    I agree that the medical establishment is effed up, but I still think they are a good place to start when it comes to healing the serious things. Broken bones, cancer (ask Steve Jobs), and serious infections need more than Vitamin D therapy. Sorry I can't offer much more than that.

    Despite being slightly paranoid about doctors and their recommendations, I would go ahead and take that test.


    • #3
      So you've had the BCG vaccine? You shouldn't take the PPD, then. You are a known reactor. The chance that you have acquired TB is slight, but you would need an xray to determine if you have lesions and there is no way they'd show up so soon.

      That said, TB is one of those diseases that public health has a lot of power over. You can be confined if you refuse to take medication for known tb, at least here. I would show up to public health and give them my vaccine records.


      • #4
        Don't get too excited about your entitlement to know WHEN. Have you thought about it - it takes a while to be come symptomatic and so whether it is staff or another student, the only thing they have to go on is students on campus at the same time, weeks or months. They may try narrow it down but try think logically about the epidemiology of it.

        If you have tested positive in the past decade, you have previous exposure. If not, get the skin test and if you are negative you can then read widely and obtain further advice about getting a vaccine.

        But my advice is to stop being suspicious, if someone has a communicable disease spread by common means of human interaction with a significant latent period, how the hell can they tell you when? They are probably erring on the side of caution, hence offering the test for prior exposure (not contamination, many people have vaccine for travel, certain medical courses) as a starting point.


        • #5
          Hang on, I just realised you say you were vaccinated for TB. Why are you upset? They don't know who has been vaccinated or not, and by the sounds of it, acknowledge they have no right to know so let you know there is an issue and a first step to work out if you may be affected. You are not. If you have any reason to doubt the effect of the vaccine, get the test to see if you have an antibody response. And why are you anti skin test when you have actually had the vaccine?

          Non issue.

          But it sounds like they are trying to do the best to deal with a potential zombie apocalypse in an environment rich with humans and human contact and yu are getting upset when they are just trying to give notice and offer a solution.


          • #6
            Hi, this is going to sound strange but bear with me. Late last year I read this:
            Creamy Turmeric Tea | Mark's Daily Apple and the comments underneath were very interesting about how turmeric can be very helpful.

            I kept that information in the back of my mind as I am an English teacher with lots of snotty children. Anyway a few months later I was on the underground in Naples, when I noticed the guy next to me was reading in English. As I did not have a book that day, I thought I would look over his shoulder. What do you know he is reading an article/thesis on turmeric and how it is very helpful with tuberculosis. My main thought at the time, was 'hmmm...handy information for when society falls apart'.

            So googling turmeric and tuberculosis, I cam across this:
            . Now this is not about preventing TB, it is about helping with problems with TB medicine but it may be worth googling for more information along these lines, it seems popular in ayuverdic medicine to help with lungs.

            DISCLAIMER: I am not a scientist and I do not claim that turmeric will cure you. I offer it only because I found the interesting and unusual.

            I would never be one to say to ignore your doctor but I am assuming you want to be proactive in preventing infection, if any. And I can understand if you are scared of TB, for some reason TB scares me as well. We all have our things. I would imagine that if you do your research on the subject and keep your appointment, that if you ask smart questions you will get more information then down the phone. I would imagine though, you are not a person that would fall into the category of being particularly susceptible to the disease, but from a public health point of view, they have to be very careful and proactive.
            Life. Be in it.


            • #7
              I am not convinced there is much preventative you can do in the usual sense. TB is one of those things where the body's immune response to the TB actually destroys the lung tissue, so increasing immune response increases tissue damage. I think OP is ok, having been vaccinated. Uni just covering arse, but good they do.


              • #8
                Tuberculosis - Wikipedia, the free encyclopedia

                Lots of useful info...

                Your chances of having an active TB infection are very minor. This is an example of a hyperactive medical community and insurance agencies who are paranoid about lawsuits.