Up to 2 billion people on the planet are infected with tuberculosis - one third of the earth's population. That doesn't mean that they have contagious pulmonary TB, just that they contain the bug which has the capacity to attack them viciously at any time, especially if something weakens them, such as HIV, other illness, or malnutrition.
Most of the cases are in Africa and Asia - the so-called TB Belt which, in Africa, overlaps with the HIV Belt. (The combination of HIV and TB is termed "the perfect storm" of infectious disease.) However, over a million Americans are infected with TB.
I learned during my Yale Continuing Medical Education series this weekend that most HIV in the Northeast is transmitted by sharing needles, not via homosexual activity. I also learned that man-to-woman HIV is on the rise in the US. Woman-to-man transmission remains essentially impossible, apparently. I have been told that the rare reported cases were probably guys lying about their IV drug use or their homosexual activities.
In our New England cities, drug addiction, mental illness, HIV and TB is a common mix and a huge challenge to the dedicated docs who try to take care of these people, not only because of the medical difficulties but because these people are not reliable patients. Throw in a pregnancy too and you have a case that could take up half your time taking care of just one of these poor souls, who usually have few-to-no social supports in their lives but who also avoid, or will not cooperate with, government help.
Often, these folks break appointments as often as they make them because their lives are out of control, and nobody has the power to fix that. You send a visiting nurse, and they have moved out. "Lost to follow-up," until they reappear feeling desperately ill again.
During one of the talks, a famous clinical researcher on infectious disease just could not resist gratuitously throwing in a snarky Power Point slide mocking George Bush's intelligence (implicitly comparing it to his own, and "ours"). It always bothers me when these Ivy types (of which I happen to be one, along with Bush with his Yale BA and Harvard MBA) just assume that everyone in their audience has the same view of things...because we are, of course, the elite bien pensant folks, aren't we, all thinking alike?
Speaking of Moonbats, that reminds me of an email from a medical friend attending a medical conference and giving a talk in San Fran last week. He said that a young and lovely California doc approached him after his talk and said "I just needed to tell you that you have a special, beautiful aura."
I emailed back and asked "Was she hitting on you?"
He replied "I don't think so. I think it's just that California is a different planet."
I said "Guess so, because I think your aura is rather ordinary."
Photo: Robert Koch, the great man of infectious disease and historic benefactor of mankind, who discovered the TB, Anthrax and Cholera bugs, and created "Koch's Postulates" which made possible the conquest of most of the diseases that ravaged man through history.
