Here all aboriginal people get routinely screened for TB, as
do people who have visited countries with high incidents of TB, all immigrants
and those people working with high risk populations such as health workers,
prison staff, police, homeless shelters etc.
So, I fronted up to be screened as you do fully confident I wasn’t
likely to come back with a positive result having had my BCG vaccine when I
started my nursing training some 19 years ago.
What they didn’t tell me when I had by BCG is, that it’s really only effective
in preventing TB for half of the population who have had it.
To my total shock I was in the half of the population it didn't help as my mantoux test showed a substantial
positive result. Positive meaning, I
have been in contact with someone with active TB and need to have a chest x-ray
to see if I have any lesions and to provide a baseline x-ray for future comparison. Fortunately I have no current lesions and no
symptoms of active TB. Therefore, I officially
have been given the diagnosis of “probable latent TB”.
So what is the risk of me actually getting ‘active TB’ or
Infectious TB Disease as it's also known as? Well, they have a
software program here that calculates the risk. The doctor puts in all the information like my age, where I was born,
countries I’ve visited, my health status, whether I smoke and drink and a few
other bits and pieces of information into the program and it gives out a percentage of
risk. If the percentage is on the higher
side then treatment is strongly recommended but is only forced (by law) if active TB is present. Treatment being 9 months of antibiotics for latent TB.
Of course, this doesn’t stop you from being reinfected in the
future. My percentage was less than 5%
so I was therefore given the choice of treatment now, or just wait and, if I get
symptoms in the future start treatment then.
Chances are I could spend my life with latent TB and never actually
develop active TB. However, if the risk
changes later in life due to age, having COPD, being immune-suppressed (i.e:
having chemo), suddenly becoming an alcoholic or whatever, then I will need to
commence treatment. In case you haven’t
already guessed, I chose to wait until I have symptoms. So it
will therefore be annual chest x-rays and reporting any symptoms such as night
sweats or fevers, productive or persistent cough or blood from my cough or loss
of weight (can only dream about that
one). All seems surreal currently.
Now, as I have only been in the country a month and the test does not show recent contact but only from 3 months ago or prior, then it's seems I contracted this in New Zealand. The country that doesn’t screen for TB
routinely, that doesn’t often BCG routinely and that has LOTS of immigrants now
residing there. So actually, I feel
safer here in the Northern Territory where they take TB seriously verses at
home, in New Zealand where we largely ignore the fact that we likely have people
with active TB living amongst us.
The best prevention for TB is not a BCG injection, but rather
early detection and treatment. It’s something we don’t do well in New Zealand. So all you people who have been in contact
with me, don’t stress, I’m not contagious..........but are you? I did after all, get it from someone.
Go and ask your GP for a mantoux test and watch as he says, "We don't do that routinely" or "You'll need to pay for that as it's not covered in our funding".
It was only a few years ago we had an outbreak in the very City I lived:
http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10651417
http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10651417
In New Zealand we also now have drug resistant TB:
Here's another one in the Manawatu:
ReplyDeletehttp://www.stuff.co.nz/manawatu-standard/6973074/School-confirms-tuberculosis-case