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Roughly one of every three people on earth is infected by Mycobacterium tuberculosis. 1-3 The distribution is uneven, with the highest incidences found in southern Asia and sub-Saharan Africa. In the United States, about 13 million people have LTBI, evidenced by a positive skin test (purified protein derivative ([PPD]) but no signs or symptoms of disease. Such patients have roughly a 1 in 10 chance of active disease during their lives, with the greatest risk in the first 2 years after infection. Active dis ease occurs in over 13,000 Americans each year, resulting in about 1,500 deaths.4 (For detailed data analysis, visit the Centers for Disease Control and Prevention [CDC] website at www.cdc.gov/nchstp/tb.)

M. tuberculosis is transmitted from person to person by coughing or sneezing.2,6,18 This produces small particles known as droplet nuclei that float in the air for long periods of time. Each droplet contains one to three organisms. Thirty percent of individuals with prolonged contact with an infectious TB patient become infected.

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