Tuberculosis (TB) has been troubling man for many centuries, and is also known as consumption. It is caused by one of two bacteria â€“ we will discuss these in more depth later on â€“ and, in the 19th century, was responsible for a quarter of all deaths in Europe. There are treatments for TB that are successful, but in the less-developed parts of the world it is a matter of crisis. In this article we will take a look at what causes TB, the common TB symptoms, how it is diagnosed and treated and what you can do to minimise the risks.
One of the problems when diagnosing TB is that it can go un-noticed until it may be quite well developed. Also, many of the common symptoms of TB are synonymous with a variety of other illnesses. This can lead to confusion and late diagnosis. The main symptoms you should be aware of are as follows:
- Weight loss
- Lack of energy and listlessness
- Fever and coughs
- Loss of appetite
- Night sweats
While TB is generally found in the lungs it can in fact infect other areas of the body, with similar symptoms to those above. If you suffer from any or all of the listed symptoms you should seek medical help straight away.
The following are some facts about TB that may help you to understand the disease more readily:
- TB has been with us since the earliest known men roamed the earth
- It is caused primarily by two bacteria – Mycobacterium tuberculosis and Mycobacterium bovis
- There was no known treatment for tuberculosis until the second half of the 20th century
- Over 90% of cases occur in the developing world and are associated with poor hygiene
- TB cases have increased in line with HIV infections
- A person with TB infects on average 15 people each year
- TB is considered a global emergency by the World Health Organisation
What Is TB?
TB is an infectious disease caused by the bacteria mentioned above. It is primarily a lung disease that causes wasting in the body, and until the 20th century sufferers would have been confined to a sanatorium to prevent infection of others. The bacteria grow â€“ and die â€“ very slowly and while TB is successfully controlled â€“ to some degree â€“ in the western world, it remains a major problem in areas where there are poor hygiene standards. Those with weakened immune systems are also prone to the disease, hence its association with HIV sufferers.
The TB bacteria can be easily spread from person to person by coughing, sneezing or even just speaking. The bacteria are carried by saliva or mucus, and are inhaled by other people. Once in the body these bacteria are carried by the lymphatic system and the bloodstream around the body. The bacteria thrive in areas where oxygen is present, hence the fast growth in the lungs. Some people can inhale the TB bacteria but have an immune system that does not allow it to grow. Such people are considered infected, even though they will not display the symptoms.
When to Seek Medical Care?
You should seek medical care if you begin to display the symptoms listed above, as these may be indicative of TB or of another disease. If you have a family member who is suffering from TB, or you are in direct contact with a patient, you should have a TB test at your doctors right away. It is important to understand that contact before treatment is the most likely way of contracting TB; once treatment begins the patient is far less contagious.
Diagnosis of TB may involve the following procedures:
- Chest X-ray â€“ this is the most common form of diagnosis procedure for TB
- Tuberculin skin test: this involves the doctor injecting a small amount of a special protein fluid into your skin. The appearance of a small lump on the skin within 48 hours can indicate TB. However, this is not the most reliable test as it can return false results â€“ i.e. indicate you have TB when in fact you do not â€“ and can also fail to spot the disease in some infected patients.
- QuantiFERON-TB Gold test: This is a blood test to determine the presence of TB in the body.
- Sputum test: this test analyses the sputum from the patient for the presence of the bacteria, and is considered the most reliable indicator of TB.
Treatment of TB is done by using a combination of drugs; this is so that the bacteria can be successfully killed if it is a strain that has become resistant (see the section on drug-resistant TB later on). Treatment can take many months as the bacteria concerned are slow growing and take a long time to be eliminated. The drugs used will be discussed with you as they may be dependent upon laboratory results and can vary between patients. Treatment is largely successful and the drugs used to combat TB are being further developed over time.
The fact remains that many of us may have the bacteria in the body but are not experiencing the TB symptoms. These bacteria could become active at any time, and prevention methods are used to kill these germs before they are able to take hold. There are several medicines that can be prescribed by the doctor to help prevent TB; the well known BCG vaccine is used on children in many countries, but it is becoming less common as the risk of TB lessens in the west. Keeping to a sensible hygiene routine can also help prevent the spread of TB; also, patient with TB can help by keeping contact with uninfected persons to a minimum. The disease is most prevalent in the less developed parts of the world, where regular vaccinations take place.
The reason why multiple drugs are administered against TB is that many strains of the bacteria have developed immunity to the drugs we have available. It is known that most strains of the disease need at least two drugs used in conjunction for adequate treatment. The most frequent cause of failed treatment is where the patient stops the course of medication as they are feeling much better; they should always complete the entire course. Multidrug-resistant TB is a form of tuberculosis that is resistant to two of the main TB drugs – isoniazid and rifampicin â€“ and can take up to two years to treat successfully. Extensively drug-resistant TB is another form, thankfully a very rare one, that is extremely troublesome and requires isolation of the patient in order to prevent the disease from spreading.
Is There a Vaccine Against TB?
The well-known BCG vaccine is the only known active TB vaccine. It is administered to 90% of children across the world. BCG is relatively successful against TB in children, but its effectiveness is known to decline after a number of years. It may be used in adults with serious cases, and it is known that the drug companies are researching new TB vaccines on an ongoing basis.
There are two ways to consider the prognosis for people who contract TB: the first is that with the right medicine the patient will be cured and continue to lead a normal life. The alternative is that without treatment TB will eventually kill the patient. Fortunately TB is relatively rare in the western world, but it still kills many patients in the undeveloped countries, largely down to poor hygiene and lack of understanding. Take your medicine as prescribed, and you will most likely make a full recovery.
We hope that this article has enabled you to understand what TB is about, how to recognise the symptoms, and what to do if you suspect you have contracted the disease, and has given you an idea of what to expect if you need to be treated for tuberculosis.