Epidemiology-tuberculosis

(NEJM 2016;375:1081)

  • Transmission via aerosols;
    • untreated active dx requires airborne isolation in healthcare facilities and community isolation measures
    • must involve local public health authorities
  • Acquisition:
    • residents/travel in TB-endemic area,
    • IVDU, resident/worker in correctional facility or homeless shelter
    • close contact w/ active TB
  • Reactivation:
    • risk is 5% in first 2 yr, 5–10% overall;
    • ↑ if HIV ⊕,
    • immunosupp.
      • (anti-TNF, steroids),
      • ESRD,
      • DM,
      • cancer,
      • transplant,
      • malnourished,
      • smoker,
      • substance use disorder