Russian TB in the U.S.? Not yet, but maybe soon
Student’s tale hints at what’s to come
In the United States, only isolated cases of disease have been linked to the Russian epidemic thus far, but that may change soon, TB experts in this country say. In Massachusetts, with a sizeable population of Russian immigrants, "we’re doing a lot of testing, but we see very little disease," says Edward Nardell, MD, medical adviser to the state’s health department and professor of pulmonary medicine at Cambridge University Hospital.
"Those who come here are highly educated and used to dealing with government officials, which means they tend to resist prophylaxis especially hard," he adds. "But that picture doesn’t reflect current conditions in Russia at all. There, people in prisons are spilling over into the community, and, eventually, we’ll see some of that."
Michael Kimerling, MD, MPH, a medical director for New York City-based Public Health Research Institute and consultant with Doctors Without Borders, recounts an anecdote he says proves his point: Recently, a Russian university student who’d come to the United States to study was diagnosed with multidrug-resistant TB. When one of Kimerling’s colleagues, a physician who works at the American university where the Russian student fell sick, explained what was wrong, the student reacted with disbelief, saying, "That can’t be possible. I’ve never been in a prison."
"That means that a person from an upper-class Russian family, a family that’s able to send their child to an American university, doesn’t realize he’s at risk; but that in fact, TB is already spreading to the Russian middle classes and upper classes," he says. "To me that’s incredible. It’s how it was here in America a hundred years ago."
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