3 ms·

That’s still not an explanation. Kids in the US spend a lot of time with other kids at daycare and school. It’s a transmittable bacterial disease. Why aren’t pe

That’s still not an explanation. Kids in the US spend a lot of time with other kids at daycare and school. It’s a transmittable bacterial disease. Why aren’t people in the US getting it more? Are you saying you have to be mal/undernourished to get it?

noodlesUK 2y ago
Malnourishment is a big part according to the WHO [1] I’m no expert but I also suspect access to medical care is also a big part, as typically only active cases spread the disease. If you are symptomatic and get some antibiotics, you might not spread it to very many people. If you’re symptomatic and go without treatment for ages, then you might spread it to loads of other people. As we learned during covid, small differences in R value massively change the prevalence over time.
dghlsakjg 2y ago
https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-024-20664-w https://bmcpublichealth.biomedcentral.com/articles/10.1186/s... Unhealthy people are more vulnerable to TB, absolutely. Infections in general are more prevalent in people who are underfed, or living in bad conditions. Other risk factors are exactly what you would expect: smoking, drinking, bad fitness level, and being young or old. TB rates are basically a function of 1. how immune compromised your population is, and 2. How much access to healthcare there is in the country (poverty, basically).
valarauko 2y ago
The majority of healthy people develop a latent infection, and won't manifest symptoms in their lifetimes. The bacteria are encapsulated into nodules by the immune system, which weaken if the immune system weakens. The bacteria escape and active symptomatic infection occurs.
- dyauspitr 2y ago
  Yeah but the US has very low levels of latent TB in the population at only 4%. Compared that to places like Brazil where 40% of the population has latent TB. It’s not the climate because in Russia 80% of the population has latent TB.
  - valarauko 2y ago
    Yes, and it's a self-perpetuating cycle. If so few people have latent TB, fewer people develop active TB that will go on to infect others. As other comments have mentioned, poverty and its resultant poor health is the biggest correlation for developing active TB. I wonder if most of the Russian latent infections happened during the Soviet/Post Soviet collapse era, with newer latent infections falling off as quality of life improved over time?
    - skirge 2y ago
      quality of life improving in Russia is a very risky statement. Soviets manipulated statistics and so does current Russian government.
      - deleted 2y ago
        [deleted]
      - deleted 2y ago
        [deleted]
  - toast0 2y ago
    In order to get latent TB, you need exposure to someone with active TB. If someone with active TB meets the healthcare system, you get a rapid response from health departments. In May 2024, the Long Beach, CA declared a public health emergency [1] based on a cluster of 14 cases. This kind of reaction is typical and makes it difficult to spread to others, and keeps the levels of latent TB low. [1] https://www.longbeach.gov/press-releases/official-city-of-long-beach-statement-regarding-public-health-emergency-in-response-to-local-tuberculosis-outbreak-risk-to-population-at-large-remains-low/ https://www.longbeach.gov/press-releases/official-city-of-lo...
  - fuoqi 2y ago
    80% sounds like a BS number. It's cited on Wikipedia, but references are either "opinions" or do not contain such information at all. A proper study [1] shows mean infection rate of ~20% in the worst regions (Far East and North) with the highest rate up to 47%. The situation should be better in the western regions. For comparison, in the US studies show ~4% infection rate [2], so situation in Russia is relatively bad, but improves steadily since 90s and it's far from being catastrophic as the 80% number paints it. [1]: https://www.tibl-journal.com/jour/article/view/1706 https://www.tibl-journal.com/jour/article/view/1706 [2]: https://www.cdc.gov/tb/hcp/clinical-overview/latent-tuberculosis-infection.html https://www.cdc.gov/tb/hcp/clinical-overview/latent-tubercul...

noodlesUK 2y ago

Malnourishment is a big part according to the WHO [1] I’m no expert but I also suspect access to medical care is also a big part, as typically only active cases spread the disease. If you are symptomatic and get some antibiotics, you might not spread it to very many people. If you’re symptomatic and go without treatment for ages, then you might spread it to loads of other people. As we learned during covid, small differences in R value massively change the prevalence over time.

dghlsakjg 2y ago

https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-024-20664-w https://bmcpublichealth.biomedcentral.com/articles/10.1186/s... Unhealthy people are more vulnerable to TB, absolutely. Infections in general are more prevalent in people who are underfed, or living in bad conditions. Other risk factors are exactly what you would expect: smoking, drinking, bad fitness level, and being young or old. TB rates are basically a function of 1. how immune compromised your population is, and 2. How much access to healthcare there is in the country (poverty, basically).

valarauko 2y ago

The majority of healthy people develop a latent infection, and won't manifest symptoms in their lifetimes. The bacteria are encapsulated into nodules by the immune system, which weaken if the immune system weakens. The bacteria escape and active symptomatic infection occurs.

dyauspitr 2y ago
Yeah but the US has very low levels of latent TB in the population at only 4%. Compared that to places like Brazil where 40% of the population has latent TB. It’s not the climate because in Russia 80% of the population has latent TB.
- valarauko 2y ago
  Yes, and it's a self-perpetuating cycle. If so few people have latent TB, fewer people develop active TB that will go on to infect others. As other comments have mentioned, poverty and its resultant poor health is the biggest correlation for developing active TB. I wonder if most of the Russian latent infections happened during the Soviet/Post Soviet collapse era, with newer latent infections falling off as quality of life improved over time?
  - skirge 2y ago
    quality of life improving in Russia is a very risky statement. Soviets manipulated statistics and so does current Russian government.
    - deleted 2y ago
      [deleted]
    - deleted 2y ago
      [deleted]
- toast0 2y ago
  In order to get latent TB, you need exposure to someone with active TB. If someone with active TB meets the healthcare system, you get a rapid response from health departments. In May 2024, the Long Beach, CA declared a public health emergency [1] based on a cluster of 14 cases. This kind of reaction is typical and makes it difficult to spread to others, and keeps the levels of latent TB low. [1] https://www.longbeach.gov/press-releases/official-city-of-long-beach-statement-regarding-public-health-emergency-in-response-to-local-tuberculosis-outbreak-risk-to-population-at-large-remains-low/ https://www.longbeach.gov/press-releases/official-city-of-lo...
- fuoqi 2y ago
  80% sounds like a BS number. It's cited on Wikipedia, but references are either "opinions" or do not contain such information at all. A proper study [1] shows mean infection rate of ~20% in the worst regions (Far East and North) with the highest rate up to 47%. The situation should be better in the western regions. For comparison, in the US studies show ~4% infection rate [2], so situation in Russia is relatively bad, but improves steadily since 90s and it's far from being catastrophic as the 80% number paints it. [1]: https://www.tibl-journal.com/jour/article/view/1706 https://www.tibl-journal.com/jour/article/view/1706 [2]: https://www.cdc.gov/tb/hcp/clinical-overview/latent-tuberculosis-infection.html https://www.cdc.gov/tb/hcp/clinical-overview/latent-tubercul...