Issue link: https://tmcpulse.uberflip.com/i/856438
t m c » p u l s e | a u g u s t 2 0 1 7 22 The results of this new procedure were astounding. Initially, they found that 15 percent of adults accompanying the children to the hospital had undiagnosed TB disease, according to Starke. In the United States, it has been common practice to require family members and people residing in the same household as an infected person to begin antibiotic treatment—much like White's family did once she was diagnosed. "For 40 years, the World Health Organization has said the following: if you have Uncle Eddie at the house, look at all the kids in the house less than five," Starke said. "If they're sick, go get them diagnosed. If they are well, give them six months of Isoniazid. In other words, treat them for TB infection. Even if you don't give them a blood or skin test, assume they are infected and treat them." Despite this long-standing recommendation, high-burden countries are just now beginning to comply, Starke said. China and India have been labeled high-burden because their rates of TB are 30 to 50 people out of 100,000, accounting for one-third of the world's TB. "It's been a resource issue, but now they are starting to wake up to the fact that, oh wow, we can prevent a lot of this with pretty simple, easy and cheap measures," Starke said. Like White, though, many people do not know where or how they contracted the disease. "Right before I was diagnosed with TB, I found out I had hepatitis C," White said. "And after I had TB, I found out I had diabetes. … My whole body started breaking down." Starke said TB is a question of bulk and degree. "There are just that many people who are infected who go on and develop the disease," he said. "If the world suddenly got smart and woke up and decided it wanted to go out and find people who had the infection and treat them so they wouldn't develop the dis- ease, which is particularly true for children, we could very rapidly knock down the number of people developing the disease." In addition to finding an effective vaccine, the real break- through for care would be identifying patients with TB infection— diagnosing and treating them before it spreads. "I think one of the themes here, if you will, is that the face of TB is changing," Starke said. "The Texas Medical Center, including Ben Taub, may take care of more TB patients than any other single health facility in the United States. We have tremendous expertise here and there is a rich history of care going back decades." During her last visit with Guy, nearly one year to the day of her diagnosis, White found out she no longer needed to take her tuberculosis medication. She was, for all intents and purposes, cured. Although she will always have scars on her lungs, White is enjoying the fact that she is free of TB and can go back to doing some of her favorite things—fishing, going on long walks and enjoying Johnston's home cooking. "I have a life now," White said. "I think we are going to celebrate. Go pig out—maybe have some rice and beans and oxtail and go swimming in my pool." After finishing treatment for TB, White relaxes with her family at home.