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Comment by valarauko | Hacker News Reader

The majority of healthy people develop a latent infection, and won't manifest symptoms in their lifetimes. The bacteria are encapsulated into nodules by the immune system, which weaken if the immune system weakens. The bacteria escape and active symptomatic infection occurs.

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Yeah but the US has very low levels of latent TB in the population at only 4%. Compared that to places like Brazil where 40% of the population has latent TB. It’s not the climate because in Russia 80% of the population has latent TB.

Yes, and it's a self-perpetuating cycle. If so few people have latent TB, fewer people develop active TB that will go on to infect others. As other comments have mentioned, poverty and its resultant poor health is the biggest correlation for developing active TB. I wonder if most of the Russian latent infections happened during the Soviet/Post Soviet collapse era, with newer latent infections falling off as quality of life improved over time?

quality of life improving in Russia is a very risky statement. Soviets manipulated statistics and so does current Russian government.

In order to get latent TB, you need exposure to someone with active TB. If someone with active TB meets the healthcare system, you get a rapid response from health departments. In May 2024, the Long Beach, CA declared a public health emergency [1] based on a cluster of 14 cases. This kind of reaction is typical and makes it difficult to spread to others, and keeps the levels of latent TB low.

[1] https://www.longbeach.gov/press-releases/official-city-of-lo...

80% sounds like a BS number. It's cited on Wikipedia, but references are either "opinions" or do not contain such information at all.

A proper study [1] shows mean infection rate of ~20% in the worst regions (Far East and North) with the highest rate up to 47%. The situation should be better in the western regions. For comparison, in the US studies show ~4% infection rate [2], so situation in Russia is relatively bad, but improves steadily since 90s and it's far from being catastrophic as the 80% number paints it.

[1]: https://www.tibl-journal.com/jour/article/view/1706

[2]: https://www.cdc.gov/tb/hcp/clinical-overview/latent-tubercul...

I guess it depends on what’s considered trustworthy. I wouldn’t trust a Russian paper as far as you could throw it unless it was in math or physics.

Russia actually spent quite a lot of resources on TB, especially during the late Soviet and the early Russian history.

All children and professionals working with children are receiving yearly TB testing ("Mantoux test"). Prisons used to be a major vector, but that was reduced by doing TB prevention (antibiotics).

Nobody likes getting TB.

But you will trust any unsubstantiated slander disseminated in mass media by interested parties as long as it paints Russia in a bad light. Got it.

Russia did this to themselves. Objectively, for what it once was Russia has horrific metrics around healthcare, alcohol consumption, HIV, drug use, food prices, human rights or any kind of sustainability initiative.

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