IntroductionThis paper will discuss the recent news article reporting an outbreak of Tuberculosis (TB) in Minnesota. The article, written by Leahy (2016), details significant concerns surrounding the spread of TB in the city and potential ways in which the disease can be contained.

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Highlights
Leahy (2016) states that 22% of refugees in Minnesota have tested positive for latent TB, compared to just 2% of the general population in the US. The article also details a 2% rise in TB cases in the city between 2014 and 2015, with being born in Somalia seemingly the most common risk factor for the disease.

Health Risk
The Centre for Disease Control aimed to eradicate TB by 2010; this aim has been unsuccessful despite a significant decline in cases over the past 20 years. However, Leahy (2016) reported an increase of 1.7% in TB cases throughout the US over the past 12 months, which is the first increase since 1989. There are around 500 – 600 deaths per year in the US from TB.

Population at Risk
The article states that there were 9563 reported cases of TB in the US in 2015, with 66% of these being in foreign-born refugees. This suggests that there is a greater risk of disease within the immigrant population; however, a third of all cases occur in US nationals indicating that the anyone within the population is at risk of contracting the disease.

Primary Prevention
There is no detail of any primary prevention of the disease in the article, although it is known that there is a vaccine available to prevent TB.

Secondary Prevention
Leahy (2016) indicates that all refugees are offered a screening test for latent TB during the domestic refugee health examination; however, the article does not detail the percentage uptake of this screening test. Latent TB is not contagious; however, 10% of latent TB cases develop into active, contagious TB if not treated with antibiotics.

Public Health System Response
In order to eradicate the disease, public health officials have called for increased testing of refugees and possible prevention of entry into the country for those who test positive.

Prevention
Whilst Leahy (2016) does not discuss significant preventative measures, it is clear that the most effective prevention for US nationals would be a comprehensive vaccination program similar to that adopted in the UK, which has an 80% effectiveness against the most severe forms of the disease (Crisp, 2013). All refugees entering the country should be systematically screened for the disease and immediately treated if testing positive to latent TB. This would prevent the spread of the disease amongst the unvaccinated immigrant population and save approximately $17,000 per case of active TB for treatment. From a personal viewpoint, when working with patients with TB, I will ensure that I have consulted with infection control and adopted personal protective measures to prevent contraction of the disease.

    References
  • Crisp, D. (2013). The role of the BCG vaccine in preventing tuberculosis in the UK. Practice Nursing, 24(10), 496-500.
  • Leahy, M. (2016). 22 Percent of Resettled Refugees in Minnesota Test Positive for Tuberculosis – Breitbart. Breitbart.