Health Matters: Dealing with tuberculosis concernsDr. Joshua Wynne answers questions about tuberculosis.
By: Dr. Joshua Wynne, Grand Forks Herald
Q. I’ve had a cough for a week. Given the tuberculosis outbreak in Grand Forks, should I be concerned that I have TB?
A. In all likelihood, the answer is no. As you mention, there have been 15 reported cases of TB in Grand Forks, with five cases in youngsters and 10 in adults. But to contract TB, one needs close contact with someone who is infected, and you can be sure that the public health officials in Grand Forks have contacted all of the close contacts of the infected patients. So if you haven’t had contact with the patients or heard from the Health Department, your cough is much more likely to be due to a virus.
There have been a rash of such viral infections recently in North Dakota, but viral infections of the upper respiratory tract usually are self-limited and more annoying than serious. Antibiotics don’t help with viral infections, although there are two medicines that can be used in certain situations to treat severe viral infections. But for most of us, the cough usually resolves on its own in a week or two.
You should be concerned and seek medical attention if the cough lasts longer than a week or two; if you cough up green or yellow phlegm; if there is any blood in the phlegm; if you have associated symptoms such as severe fatigue, fever, sweating at night, weight loss, shortness of breath, or wheezing; or if you also have a serious systemic infection like diabetes or cancer that may have compromised your immune system.
In some cases, a persistent hacking cough that isn’t associated with much phlegm production may be caused by a bug that is responsive to antibiotics, so again, you should see your health care provider if your cough doesn’t resolve soon. But I suspect that you’ll be fine within the next few days. If not, see your provider, but in the absence of other symptoms, you almost certainly don’t have tuberculosis. And remember to get your flu shot!
Q. I have a desk job that entails a lot of computer keyboard work. My right hand has developed pain, tingling, and numbness, and I’ve been diagnosed with carpal tunnel syndrome. What is it?
A. Carpal tunnel syndrome occurs when there is pressure on the nerve that goes to the thumb side of the hand, typically caused by a buildup of scar tissue. A variety of diseases can lead to carpal tunnel syndrome, but many people like you seem to develop it with repetitive wrist motion; however, it remains controversial as to the exact relationship between work-related repetitive motion and the condition.
Symptoms like yours are common and occur in the distribution of the median nerve, which includes two-thirds of the thumb side of the hand; typically, the thumb, index, middle and half of the ring finger are involved. Treatment includes the use of a wrist splint and injection of anti-inflammatory medicines (corticosteroids). In some cases surgery is necessary, but the results of surgery usually are good.
Wynne is vice president for health affairs at UND, dean of the School of Medicine and Health Sciences, and a professor of medicine. He is a cardiologist by training.
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