Protecting Your Family From Tuberculosis

by Marta Perrone

In 1989, the Center for Disease Control and Prevention announced the goal of eliminating Tuberculosis (TB) from the United States by year 2010. However, today TB and drug-resistant TB cases are continuously reported in every state, and 10 to 15 million persons in the United States are infected.

In the United States, and especially in California, Tuberculosis is largely an immigrants' affliction. In a recent report by the State's Department of Health Services, California led the nation in the number of new TB cases reported last year- 2,989. Three-quarters of those were among people born outside of the United States and nearly a fifth were younger than 16. Many immigrants come infected but undetected due to inadequate screening of new immigrants, including foreign students, workers and visitors. This, of course, has given fuel to the fire over illegal immigration. With its large immigrant population and dense neighborhoods, Los Angeles County is a TB stronghold. Those infected may think it is merely a cold and not seek medical help until they are really sick. Understanding TB and how it is carried and contracted should be of interest to you if you have an immigrant working on a daily basis with you and your family members.

Tuberculosis (TB) is a disease caused by bacteria that usually attacks the lungs. It travels through the blood and can also attack other parts of the body such as the kidneys, spine and brain. If not treated properly, it can be fatal. TB is spread through the air from one person to another when a person with the active TB disease of the lungs or throat coughs or sneezes. People may breathe in these bacteria and become infected. However, not everyone infected with TB bacteria actually becomes sick. In most cases, the people who breathe in the bacteria can fight it so that it does not grow. The bacteria can be inactive, but remains alive in the body and can become active later. This is what is called "latent TB infection." People who have latent TB infection have a positive skin test reaction but do not feel sick, have any symptoms, nor can they spread TB, and they have a normal chest x-ray and sputum (phlegm) test; however, some who have weak immune systems do go on to develop TB disease. Babies and young children have weak immune systems. People with active TB can get treated with medicine and get cured and those with latent TB can take medicine so that they will not develop the active TB disease.

How do you confront a prospective employee with the concept of getting TB tested prior to coming to your home to work with your child? Your decision to hire this employee would be subject to the test results. The way to approach the job offer would be to say that you would like to have the following medical tests performed, and that you will be concurrently checking references along with criminal and DMV records to determine your decision. If the TB skin reaction test comes back positive, you would need a chest x-ray to see if the TB is in effect latent and inactive. As mentioned earlier, with medication, this condition can be controlled and never develop into active TB. What is most important, however, is that you know the test results so that you can incorporate this information into your decision making when hiring household help.