Which of the following family members exposed to TB would be at highest risk for contracting the disease?
A. 45-year-old mother
B. 17-year-old daughter
C. 8-year-old son
D. 76-year-old grandmother
Correct Answer: D. 76-year-old grandmother
Elderly persons are believed to be at higher risk for contracting TB because of decreased immunocompetence. Other high-risk populations in the US include the urban poor, AIDS, and minority groups. Tuberculosis is present globally. However, developing countries account for a disproportionate share of tuberculosis disease burden. In addition to the six countries listed above, several countries in Asia, Africa, Eastern Europe, and Latin and Central America continue to have an unacceptably high burden of tuberculosis.
Option A: In more advanced countries, high burden tuberculosis is seen among recent arrivals from tuberculosis-endemic zones, health care workers, and HIV-positive individuals. Use of immunosuppressive agents such as long-term corticosteroid therapy has also been associated with an increased risk.
Option B: More recently, the use of a monoclonal antibody targeting the inflammatory cytokine, tumor necrotic factor-alpha (TNF-alpha) has been associated with an increased risk. Antagonists of this cytokine include several monoclonal antibodies (biologics) used for the treatment of inflammatory disorders.
Option C: TB is especially a problem among patients with HIV/AIDS. Resistance to multiple anti-tuberculosis medications including at least the two standard anti-tuberculous medications, Rifampicin or Isoniazid, is required to make a diagnosis of MDR-TB.
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