B. When should TB be suspected? 1. Anyone who breathes is susceptible to TB infection and disease, but is the person at high risk? 2. In the U.S., TB is more common among certain groups and in certain settings a) close contacts of a person with active TB b) foreign-born persons from countries where TB is very common c) high-risk groups i. the homeless ii. inmates of jails and prisons iii. residents of long term care facilities (for example, nursing homes) iv. previously-infected persons of all ages (PPD reactors) v. some ethnic groups, notably African American and Native Americans have higher rates vi. HIV-infected and other immune compromised persons vii. substance use (alcohol abuse, injection drug use, other drug abuse)