TB has been a gradually diminishing presence in the United States for decades, and currently there are only 2.4 cases per hundred thousand people in our country.

When I was in medical school, TB was still a big problem, and we learned about the fever, night sweats, weight loss and coughing up blood from active tuberculosis. With any of these symptoms, you should, of course, check with a physician.

These severe infections still happen but, currently, tuberculosis occurs primarily in immigrants from other countries, homeless people, prison inmates, people with Immune deficiency, such as cancel therapy and HIV infection.

TB is also  more common in Asians, Native Americans and Eskimos, and Hispanics.

The Ordinary middle class American citizen these days is unlikely to catch tuberculosis, unless they are exposed to somebody that has an active, open case, more likely in people described above.

On first contact, the Tubercle bacillus is almost always controlled by the immune system. Most of these primary cases are without symptoms, and after a few weeks could be picked up by an immune blood test, called the T-spot.TB, or the skin tuberculin test. The chest x-ray can also show a spot on the lung with primary tuberculosis. it is with reactivation that the severe symptoms of secondary TB, described above, can occur.

My own inclination would be to get tested with exposure to any of the groups mentioned above, especially if they have a cough.

Incidentally, there was a dip in tuberculosis incidence during the contagion versus COVID-19 pandemic, showing one more advantage in avoiding big, inside groups.

Catching tuberculosis at the earliest possible moment still continues to be important, especially since long drawn out disease in individuals who have defective immune systems has led to the development of drug resistant organisms.

—Dr. C.