Tuberculosis

Tuberculosis (TB) is an infectious disease usually caused by Mycobacterium tuberculosis (MTB) bacteria. Tuberculosis generally affects the lungs, but can also affect other parts of the body. Most infections do not have symptoms, in which case it is known as latent tuberculosis.

About 10% of latent infections progress to active disease which, if left untreated, kills about half of those affected.

The classic symptoms of active TB are a chronic cough with blood-containing sputum, fever, night sweats, and weight loss.

Symptoms

Chronic cough, fever, blood in the sputum, weight loss

Causes

Mycobacterium tuberculosis

Risk factors

Smoking, HIV/AIDS

Diagnostic method

CXR, culture, tuberculin skin test

Differential diagnosis

Necrotizing pneumonia, histoplasmosis, sarcoidosis, coccidioidomycosis

Treatment

Antibiotics

Frequency

25% of people (latent TB)

Deaths

1.6 million (2017)

How to prevent Tuberculosis

Avoid exposing yourself to people with active TB.

Obviously the most important precaution you can take to prevent TB is to avoid being around people with active TB, which is highly contagious, especially if you have already tested positive for latent TB. More specifically:

In particular, it is important to avoid spending time with TB patients in warm, stuffy rooms.
If you are forced to be around TB patients, for example if you work in a care facility where TB is currently being treated, you will need to take protective measures, such as wearing a face mask, to avoid breathing in the TB bacteria.

If a friend or family member has active TB, you can help to rid them of the disease and lessen your own risk of contracting it by ensuring that they strictly follow treatment instructions.

Know if you are “at-risk”.

Certain groups of people are considered to be more at-risk of developing TB than others. If you are a member of ones of these groups, you need to be more vigilant about protecting yourself from TB exposure.
Some of the main at-risk groups are as follows:

  • People with weakened immune system, such as those with HIV or AIDs.
  • People who live with or care for someone with active TB, such as a close relative or a doctor/nurse.
  • Healthcare and social workers who serve high-risk patients, such as people who are homeless.
  • People born where TB is common, including children, and anyone who has immigrated within the last five years from areas that have a high TB rate.
  • People who live in crowded, confined spaces such as prisons, nursing homes, or homeless shelters.
  • People who abuse drugs and alcohol, or have little or no access to proper health care.
  • People who live in or travel to countries where active TB is common, such as countries in Latin America, Africa and parts of Asia .

Lead a healthy lifestyle

People who are in poor health are more susceptible to the TB virus, as their disease resistance is lower than in healthy people. Therefore, it is important to do your best to lead a healthy lifestyle.

Eat a healthy, balanced diet with plenty of fruit, vegetables, whole grains and lean meat. Avoid fatty, sugary and processed foods.
Exercise often, at least three to four times a week.

Try to incorporate some good cardiovascular exercise into your workouts, such as running, swimming or rowing.

Cut down on alcohol consumption and avoid smoking or taking drugs.

Get plenty of good quality sleep, ideally between seven and eight hours a night.

Maintain good personal hygiene and try to spend as much time as possible outdoors, in the fresh air.

Get the BCG vaccination to prevent TB.

The BCG (Bacille Calmette-Guerin) vaccine is used in many countries to help prevent the spread of TB, especially among small children. However, the vaccine is not commonly used in the US, where infection rates are low and the disease is highly treatable.

Therefore, the CDC does not recommend the vaccine as a routine immunization.

In fact, the CDC only recommends the BCG vaccine for U.S. citizens in the following situations:

  • When a child has been tested negative for TB but will continue to be exposed to the disease, especially strains that are resistant to treatment.
  • When a healthcare worker is continually exposed to tuberculosis, especially strains that are resistant to treatment.
  • Before travelling to another country where tuberculosis is prevalent.

How to recognise Tuberculosis symptoms

Notice any unusual coughing.

TB usually infects the lungs, breaking down the tissue there. Our body’s natural response is to remove the irritant by coughing. Figure out how long you’ve been coughing; TB usually lasts for more than 3 weeks and may include such worrisome signs as bloody sputum.

Consider how long you’ve taken over the counter cold/flu medications or antibiotics for a respiratory infection with no relief. TB needs very specific antibacterial drugs, and to start therapy requires screening and confirming TB.

Look for discharge when coughing.

Have you noticed any sputum (sticky discharge) when coughing? If it smells and is dark, it can be any type of bacterial infection. If it’s clear and odorless, it can be a viral infection. Take notice if there’s been any blood when coughing into your hands or tissues.

When TB cavities and nodules form, nearby blood vessels may get destroyed, leading to hemoptysis coughing up blood.
You should always seek expert medical advice when you cough up blood. He or she will be able to advise you on how to proceed.

Pay attention to chest pain.

Chest pain can suggest a wide variety of issues, but when taken together with other symptoms, they can point to TB. If you feel a sharp pain, it can you point to a specific, localized area.

Note particularly if it hurts when you apply pressure to that area, or if it hurts when you breath in and out or when you cough.

TB forms hard cavities and nodules against the lungs/chest wall. When we breath, these hard masses cause damage to the area, leading to inflammation at the site. Pain tends to be sharp, localized to a specific area, and reproducible when we put pressure on it.

Take note of unintentional weight loss and lack of appetite.

The body has a complex response to the Mycobacterium tuberculosis bacteria that results in poor nutrient absorption and altered protein metabolism.

These changes might persist for months without your noticing them.
Look in the mirror and note any changes to your body. If you can see the outline of your bones, this indicates you don’t have enough muscle mass due to lack of protein and fat.
Measure your weight on a scale. Use a previous but recent weight from when you were feeling healthy as a comparison. Weight changes vary, but you should address any drastic changes with your healthcare provider.
Note whether your clothes feel looser
Keep track of how often you’ve been eating and compare it to when you last felt healthy.

Do not ignore fever, chills and night sweats.

Bacteria usually reproduce at around normal body temperature (98.6 F). The brain and immune system respond by raising the body’s temperature to stop the bug from reproducing. The rest of the body detects this change, then attempts to adjust to this new temperature by contracting muscles (shivers), making you feel chills. TB also causes specific inflammatory proteins that aid in fever production to be produced.

Beware of latent TB infection.

A latent TB infection is dormant and not infectious. The bacteria simply resides in body with no harm. Reactivation can occur in those with reduced immunity, as listed above. It can also occur with increased age due to weakening of the immune system. Reactivation sometimes also occurs for other, unknown reasons.

Be able to distinguish TB from other respiratory infections.

There are many other conditions that TB could be mistaken for. You don’t want to wait out a simple cold virus only to find out that you have something more serious on your hands. To differentiate between TB and other conditions, ask yourself the following questions:

  • Is there clear mucus liquid dripping from my nose? A cold will cause congestion/inflammation of the nose and lungs that leads to mucus dripping or running out from the nose. TB will not present with a runny nose.
  • What is being produced by my coughing? Viral infections and the flu tend to have a dry cough or produce a white mucus. Bacterial infections found in the lower respiratory tract produce brownish sputum. TB, though, typically produces a cough over 3 weeks and can produce a hallmark bloody sputum.
  • Am I sneezing? TB does not cause sneezing. This is usually a sign of the cold or flu.
  • Do I have a fever? TB can cause a fever of all levels, but those who have the flu typically have fevers of more than 100.4°.
  • Do my eyes appear watery/itchy? The cold typically presents with these symptoms, but not TB.
  • Do I have a headache? The flu typically presents with headaches.
  • Do I have joint and/or body aches? The cold and flu can cause this but it is more severe with the flu.
  • Do I have a sore throat?Look inside your throat and see if it appears red, swollen and painful when swallowing. This is seen mainly with cold but can appear with the flu as well.

2 thoughts

  1. Very insightful post. My favorite section is ‘How to prevent Tuberculosis’. Better to take preventive measures than managing a curative measure which does not guarantee reversing the infection. Great job David and thanks for sharing.

    Like

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s