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TB infrequent; serious threat
Health advice
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Although we’re often suspicious of the person hacking next to us, we usually chalk the cough up to an upper respiratory infection. It likely never occurs to us that the sick person in the grocery store or at the bank might have the once-dreaded “white plague” — tuberculosis. But TB is still a concern. It continues to infect one-third of the world’s population and kills 2 million people each year. It is a global problem, but it’s preventable and curable.
World TB Day, which is observed each year on March 24, commemorates the date in 1882 when Dr. Robert Koch announced his discovery of mycobacterium tuberculosis, the bacteria that causes TB. The annual World TB Day provides an opportunity to communicate TB-related problems and solutions and to support worldwide TB-control efforts. The CDC and its partners are committed to eliminating TB in the United States.
Tuberculosis is an airborne disease caused by a rod-shaped bacterium, mycobacterium tuberculosis. The disease is a serious problem even though the number of cases in the United States has declined since 1996. According to the World Health Organization, tuberculosis is the leading cause of death among adults due to a single infectious agent.
While the TB bacteria can attack any part of the body, it more commonly attacks the lungs. TB in the lungs or throat is contagious but it is not contagious when TB is only in other parts of the body, such as the kidney or spine. If a person with active TB coughs or sneezes near you, there’s a slight chance you may inhale microscopic TB bacteria. Most people who become infected have spent time in close contact with a person who has infectious TB in the lungs.  
When someone inhales the TB germ and becomes infected with the disease, the body’s immune system works to stop the infection from growing. A healthy immune system can usually stop the disease from growing and can place the TB germ in an inactive state. When this occurs, the person is not sick, does not have any symptoms and is not contagious. They will, however, have a positive tuberculin skin test and may develop active TB in the future if not treated for the latent TB disease. If the immune system does not stop the TB germ from growing, the person develops active TB. A person with active TB will have a positive tuberculin skin test, an abnormal chest X-ray and a positive sputum test. They may also spread the disease to others. A person with active, untreated TB will infect an average of 10-15 people each year.
It is important to understand there is a difference between being infected with TB and having TB disease. Someone who is infected with TB has the germs in their body but the body’s defenses protect them and they are not sick. Someone with TB disease is sick, and if not properly treated can spread the disease to others. The disease can be fatal if untreated.

Symptoms of TB:
• Pain in the chest
• A bad cough that lasts longer than two weeks
• Coughing up blood or sputum from deep inside the chest
• Weakness or fatigue
• No appetite and weight loss
• Chills and fever
• Sweating at night
Tuberculosis is not easily spread and infection usually requires repeated exposure to TB bacteria, but it does spread more readily in cramped, enclosed and poorly ventilated spaces where the chance of repeated exposure is greater.
Drugs offer the most effective treatment for TB. However, successful drug therapy may require taking two to four drugs for six to 12 months to completely destroy the TB bacteria. People with TB need to wear a mask in public until they are no longer contagious. Although TB is usually not contagious after a few weeks of treatment, a full course of therapy is necessary to kill all the bacteria. Failure to properly complete treatment can create drug-resistant strains of the disease that may render the treatment ineffective. If unrecognized or improperly treated, or if patients do not take prescribed medications properly, TB can become incurable. This development may cause TB to progress to a potentially lethal stage. So it is very important to take the drug treatment exactly as directed and not to skip doses.
The purpose of the Coastal Health District’s tuberculosis program is to control transmission and prevent illness and disease due to tuberculosis. This is accomplished by providing services to TB patients, contacts and other infected people to make all infectious TB cases non-infectious and prevent infected persons from becoming infectious. Services include PPD skin tests, chest x-rays, referrals, sputum collections, medication and patient monitoring. TB services are available in all county health departments during regular clinic hours.

Ratcliffe is a consultant to the Coastal Health District. You can call her at 876-6399.
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Visit with children a real eye-opener
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One of my favorite activities as a state senator is when I get to speak to students at our local schools. This year, I spoke to third-grade students at May Howard Elementary and Marshpoint Elementary in Chatham County and Button Gwinnett Elementary in Liberty County.
The students from each of the schools had been studying civics and were familiar with the three branches of government — executive, judicial and legislative. I explained my role as a senator in the legislative process and told the children how the citizen legislature in the state of Georgia works.
Presenting each of the schools with a Georgia state flag, I explained the three principles for which the state flag stands — wisdom, justice and moderation — and had them recite the pledge to the flag with me. 
The students at all three schools were bright, respectful and well-disciplined — a tribute to their families and especially to their teachers, who had prepared the students for my visit with ideas for great questions.
The students in Ms. Hutchinson’s class at Marshpoint Elementary were impressive in singing the preamble to the Constitution during my visit. What a great way to learn such an important part of our nation’s history — another wonderful example of the great job our teachers are doing.
I was delighted last week to receive thank-you letters from some of the students. Here are excerpts from a few of their letters:
 
Dear Mr. Carter,
Thank you for taking the time out of your busy schedule to come speak to us. I learned so much! I learned that there are two kinds of Pledge of Allegiances. That is pretty cool.
Do you travel all over the world do you? I really like that you taught me more about the three branches of government.
— Megan
 
Dear Sen. Carter,
Thank you for telling us about your job and your favorite thing about your job. I liked the Georgia state flag. I still have more questions. Do you have to work on Saturday and Sunday? Are you the only one who makes the laws?
Yours truly,
Ryleigh 


Dear Sen. Buddy Carter,
Thank you for coming and letting us have a little bit of your time. I want you to know that I learned something new. The Georgia pledge! Justice, wisdom and modesty! Thanks again!
— Liam
 
Dear Sen. Buddy Carter,
Thank you for coming and helping us learn more about the government and some of your job. Thank you for giving us a Georgia flag. It was fun when you came. Thank you for giving us some questions so we could answer them.
P.S. Did you ride in a limousine? I was going to ask you a question but then I forgot. But now I remember. How many rooms are there where you work? You can send me a note if you can.
Your friend,
Erin
 
I’m uncertain whether the students learned as much from me during my visit as I learned from them. One thing that I was reminded of was the honesty that comes from the innocence of childhood. I wasn’t quite sure how to interpret some of the questions, such as the one asked in this letter:
 
Dear Sen. Carter,
I loved your speech. Thanks for coming to our school. I think my favorite part was when we held the flag. It was so fun! I have a question: How many people voted for you?
Sincerely,
Shelly
 
I also was more than a little concerned about a recurring question in the thank-you notes that was posed to me during one of my visits by a beautiful, brown-eyed girl who, with a very serious look on her face, asked “Did you ever get re-elected be-fore?”


What a great group of young people! My faith and hope in our future has been reassured. What an amazing job our families and teachers are doing on a daily basis to support and encourage our next generation. Thank you for your dedication to teaching our leaders of tomor-row.

Sen. Buddy Carter can be reached at Coverdell Legislative Office Building (C.L.O.B.) Room 301-A, Atlanta, GA, 30334. His Capitol office number is 404-656-5109

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