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Routine Cough in a Lao Immigrant - Answer B

Author(s): Dr. J. Carey Jackson

b) False.  Immigrants of his age and from areas where smallpox immunizations were common often confuse PPD screening with the smallpox scar. PPD screening is not used in the developing world as a means for screening for tuberculosis. There are few programs for treating latent TB abroad, where the focus is on active disease. He is likely confused, if he was treated it was for active TB or for something else. Therefore his PPD status is unclear, he has not likely been treated with INH, and since he is a poor older immigrant from an endemic country in the U.S. under five years, he is among the high risk groups for reactivation of latent TB. The highest rates of TB in the U.S. are among the foreign born from Vietnam, Mexico, and the Philippines. The small number of Lao make it harder to register the rates, but they are equally at risk.

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