friendship in the time of tuberculosis

August 1, 2006 6:32 AM

A new friend disclosed that they had active TB in late 2005. How to respond?

I'm immune-compromised and curious as to whether or not I should be concerned about exposure. This is a platonic, same-sex friend. I know little about the disease or what I should be careful about. Internet research is somewhat vague on the topic.

posted by anonymous to health & fitness (8 comments total)

Why not ask them the same question you posted here? They may have already discussed these types of scenarios with their doctor (it might even be why they disclosed it in the first place) and I find nothing wrong with the approach you've taken here.

IANAD, but I read through some information on treatment and it looks like the relapse rate is very low after the first 6 months of treatment. We're still relatively close to that bracket in Q3 2006 so I would seriously consider talking to your friend about this.

Explain your health situation first (as they did to you). Any reasonable friend would understand your concern.
posted by purephase at 7:13 AM on August 1, 2006

I'm not a doctor, I recommend speaking to your doctor about this.

However, I think this CDC page is very relevant to the question:

http://www.cdc.gov/NCHSTP/TB/faqs/qa_introduction.htm

This seems to suggest that being immuno-compromised does increase the risk of infection but also seems to suggest that it would have developed rapidly in such a person and you would have displayed the listed symptoms of active infection already.

Your doctor can administer a test to determine if you have latent TB.
posted by empyrean at 7:15 AM on August 1, 2006

IANAD, but I am a microbiologist. If you are immunocompromised, exposure to tuberculosis is very dangerous for you. I doubt that you have latent TB (like empyrean said, you would be more likely to come down with active disease). If your friend was effectively treated and no longer has active disease, he/she is no longer shedding bacteria and it shouldn't be a problem. Both of you should probably ask your doctors about this.
posted by emd3737 at 7:33 AM on August 1, 2006

The test is simple - just the little pin pricks on the skin. I'd say, if you have insurance - and probably even if you don't, get it. Then, no worries if you come back clean. I had one done a few months ago. Less than no big deal.
posted by clarkstonian at 8:50 AM on August 1, 2006

Actually the tine test has been widely replaced by the Mantoux test. It's not as painless... but having gotten a Mantoux 10 years ago in the military it's not that bad.
posted by rolypolyman at 11:08 AM on August 1, 2006

Given that you're a) asking MeFi, and b) asking anonymously, I infer that you associate a social stigma with tuberculosis which prevents you from consulting conventional authorities such as doctors or medical clinics, or just asking your friend straight out about it.

I suggest that you not tiptoe around and just treat it like any other serious health issue. While certain risk groups (drug users, prisoners, etc) are more susceptible to TB, the unfortunate fact is that everyone is somewhat at risk of succumbing to the disease's resurgence.

Your friend has nothing to be ashamed of, so treat him as such.
posted by randomstriker at 12:18 PM on August 1, 2006

You say that your friend had active TB; I assume that means that your friend has been effectively treated and is no longer coughing bacteria all over. If that is the case (and you will want to confirm with your friend to be sure) you have little to worry about in terms of exposure now. There are many folks with latent TB out there, and they are not contagious.

Were you around them during a time in the past when they could have been contagious? If that is the case, you need to talk to your doctor, get a skin test, and if it comes back positive for latent TB, you will probably need to undergo a round of preventative antibiotics to help insure that you don't get sick. Yes, it is unlikely that you have a latent infection that has not shown up yet, but for your safety and peace of mind, if you've been exposed to active TB, you should get it checked out.

And regardless of whether you were exposed when your friend was sick, you need to talk to them about the situation. There is always a possibility that they will suffer a relapse, and in that case, your friend needs to know that you are particularly succeptible to TB, and need to be protected from exposure.
posted by bookish at 2:17 PM on August 1, 2006

Given that you're a) asking MeFi, and b) asking anonymously, I infer that you associate a social stigma with tuberculosis

I suspect the social stigma is probably associated with being immune-compromised, not with TB.
posted by advil at 9:29 PM on August 1, 2006