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  1. Nicholas Hart,
  2. Gisli Jenkins,
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Microbial muse

It is rare to find a poet inspired by bacteria. However, one such rarity was Hilaire Belloc who penned the following cautionary verse:“The microbe is so very smallYou cannot make him out at allBut many sanguine people hopeTo see him through a microscope.”

These sanguine people will be disappointed in the case of latent tuberculosis, where affected individuals are, by definition, smear and culture negative. Detecting latent TB is an important part of the prevention of active TB because up to 10% of people with latent TB will progress, with immune deficient and immunosuppressed patients at particular risk. In this issue of the journal, Sunny Wong and colleagues explore the use of the interferon gamma release assay (IGRA) in one at risk group, patients with autoimmune disorders (primarily rheumatoid arthritis and inflammatory bowel disease) who may receive immunosuppressive therapy (see page 64). They conclude that the IGRA test should be done before the patient starts immunosuppressive therapy. In a linked editorial, Martina Sester and Beate Kampmann argue that both IGRA and the tuberculin skin …

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