Tuberculosis diagnosis turns patients into advocates
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TB Management l QuantiFERON

Tuberculosis diagnosis turns patients into advocates
Over a decade ago, Karen and Scott Halstead spent their honeymoon in Africa and came back to San Francisco with tuberculosis – an infection that kills 1.5 million people a year. During their journey with the disease, the Halsteads have gone from patients to advocates for raising awareness on a widely neglected disease.

Karen and Scott Halstead’s 2007 honeymoon to Africa set their lives on a course they could have never imagined. It was somewhere during their travels, either on the plane or on the ground in South Africa, Zambia or Botswana, that the newlyweds were exposed to tuberculosis bacteria. After returning to their hometown of San Francisco, the tech executive developed a lingering cough, shortness of breath and overall fatigue, symptoms that Scott Halstead’s doctor misdiagnosed as a particularly stubborn flu. Around the same time, Karen Halstead, who was five months pregnant with their first child, went in for a routine prenatal visit in early 2008 and tested positive for latent TB – a milder, dormant form of the disease that does not cause immediate symptoms.

Scott had previously gotten tested with a skin test, which provided false negative results, potentially due to immune suppression from the medication he was taking for an autoimmune disease. Karen’s unexpected diagnosis triggered him to go in for another clinical evaluation, after which Scott was diagnosed with the highly contagious form of active TB.

The Halsteads never anticipated that their trip to Africa would result in contracting the world’s most common deadly infectious disease. How they reacted ensured that the disease was contained, and they have become advocates for TB prevention since the experience.
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I had visited my family in Chicago and I had had this chronic cough and wasn't feeling well, I never thought it would be TB.
Scott Halstead, Technology executive, advisor and board director, San Francisco
The diagnosis came as a major shock to the couple who led an active and healthy lifestyle. “To be honest, the only thing I really knew about TB was from movies and books based in medieval times, when you heard about people dying of consumption,” Karen admits. “I knew a little bit about TB, but thought it had been eradicated,” adds Scott.

After diagnoses, the Halsteads immediately reported to San Francisco’s public health system to start treatment. Scott Halstead was quarantined at home where he followed a regimen of four different antibiotics. “I needed to stay isolated and was pretty much confined to my house four to six weeks. The antibiotic regime lasted for around nine months in total. The side effects from the drugs were pretty serious, and it was also disruptive from a social perspective. I couldn’t see friends and family for a long period of time,” the tech executive recalls.

What made matters more worrisome was the fact that the diagnosis came as the couple was expecting their first child in just a few months. “My situation was not something common that the doctors were dealing with,” says Karen. “In the end, I took the Department of Public Health’s recommendations and I'm glad I did. I went on a course of antibiotics and I was assured that they would not affect my pregnancy or my baby,” says Karen.
Karen and Scott Halstead
Karen and Scott live in San Francisco’s Noe Valley with their two healthy children, the oldest of which Karen was carrying when she contracted TB. Both have been actively involved in fighting the disease since their recovery over a decade ago in addition to their careers. Scott is a technology executive, advisor and board director while Karen is Advertising Executive and Agency Founder of Ways & Means.
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TB is the most successful infectious disease pathogen in the world. It has been with humankind for millennia.
Dr. Masae Kawamura, Director of medical and scientific affairs, QIAGEN

Tuberculosis still continues to cause stigma today, mostly because people don't know that it is a preventable and curable illness. Due to the many misconceptions surrounding the ill-reputed disease, the advertising executive was understandably apprehensive about sharing her condition with her colleagues, fearing she might be contagious, or somehow even shunned. “I didn’t know if they would understand, because I certainly didn’t fully understand the situation,” she recalls.

Scott, who experienced an active form of TB, not only had to contact his large family in Chicago to tell them that he had been carrying TB over Thanksgiving, he also had to inform each and every person he was working with in San Francisco that they needed to get tested. “It was a stressful time to have to explain that to people and let them know that I might have infected them with something that certainly had serious consequences,” recalls Scott. Despite the discomfort of having to share the news, the couple emphasizes that the importance of containing and preventing tuberculosis is to take precautions and find out if you’re inadvertently infecting other people that you know, whether it's work colleagues or family.

Karen and Scott with family
About a quarter of the world’s population, or 1.7 billion people, carry latent TB, which lies dormant but can reactivate when the body is weakened by other stressors such as living with HIV, a compromised immune system, poor nutrition, diabetes, smoking and alcohol consumption. Only 5–10% of those infected will develop TB disease during their lifetime. When treated with antibiotics over several months, TB can be cured and its spread impeded. According to the WHO, roughly 7 million people were reported to have been provided with quality TB care in 2018, up from 6.4 million in 2017.
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I needed to stay isolated and was pretty much confined to my house four to six weeks. The antibiotic regime lasted for around nine months in total.
Scott Halstead, Technology executive, advisor and board director, San Francisco
From the onset of Scott’s treatment, Masae Kawamura was the physician in charge of San Francisco’s TB program at General Hospital back when the couple was diagnosed. She quickly became a trusted advisor to the Halsteads as they embarked on their journey towards recovery. “Tuberculosis has been a specialty of mine for 30 years,” Masae explains. “TB is the most successful infectious disease pathogen in the world. It has been with humankind for millennia and kills about 1.5 million people every year. That’s more than any other infectious disease, including HIV. Latent TB, like in Karen’s case, is very stealthy, because it can reactivate at any time, often in the first one to two years after the infection was contracted. And we certainly didn’t want her to get TB while she was pregnant,” recalls Masae. Kawamura’s decades in the field have shown her that timely latent TB testing of people at risk, not with a simple skin test but with a more specific and accurate blood test, can make an important difference.

The doctor has taken her passion to combat TB to a new level when she joined QIAGEN in early 2012 as senior director of medical and scientific affairs. “I felt that joining an international molecular diagnostic company would give me a new platform to promote good TB control practices, focusing on testing and prevention to stop the cycle of contagion,” she says. “One of the reasons I really like working for QIAGEN is that as a diagnostic company, we're constantly looking for solutions for people that need the testing. A major benefit of blood tests like QuantiFERON, is that they replace the TB skin test, a 100-year-old method with hit-or-miss accuracy. Tuberculosis skin tests often result in false positives which can lead to people taking TB drugs unnecessarily for months on end while false negatives result in patients potentially spreading the illness.
Masae Kawamura Image
Dr. Kawamura joined QIAGEN in the beginning of 2012 after working in the public health sector as a medical doctor. Currently a senior director of medical and scientific affairs for QIAGEN, she has specialized in tuberculosis for over 30 years. Kawamura and Scott Halstead both sit on the board of Vital Strategies, with the mission to help governments strengthen their public health systems to contend with the most important and difficult health challenges, including tuberculosis. 
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A major benefit of blood tests like QuantiFERON, is that they replace the TB skin test, a 100-year-old method with hit-or-miss accuracy.
Dr. Masae Kawamura, Director of medical and scientific affairs, QIAGEN
“I call TB a happy disease, because not only can you cure the active disease but you can also prevent it. We have all the tools and the antibiotics that control its spread,” says Masae. Treatment, she adds, has also markedly improved since Scott Halstead fell ill. “The traditional treatment used to be a daily drug regimen for six to nine months. Today, the preferred treatment in the U.S. lasts only three months, with just 12 weekly doses,” says Masae.

Even a decade later, Dr. Kawamura is still in touch with the Halstead family. With Dr. Kawamura’s support, the couple turned their personal experience as TB patients into advocating for others with Scott serving on the Board of Trustees for a nonprofit called Vital Strategies. “We meet once or twice a year, but apart from this work it brings me so much joy as a doctor to see them heal, go back to their normal lives and raise a family with two wonderful children who are now nine and eleven years old. That’s what we’re here for,” says Masae.
What is QuantiFERON-TB Gold Plus?
Find out more about an improved version of the industry-leading IGRA for TB detection, QuantiFERON-TB Gold Plus.
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