Tuberculosis is often regarded as a bygone disease, since its mortality rate has declined rapidly with the advent of modern sanitation practices and public health measures. Yet it’s important to remember that while there has been amazing progress in preventing and treating tuberculosis, it still affects millions of people each year and is the leading cause of death from an infectious disease.
March 24th is World Tuberculosis Day, recognizing the anniversary of Dr. Robert Koch’s discovery in 1882 of the Myobacterium tuberculosis bacteria that causes the disease. This breakthrough allowed for considerable advances in screening methods, treatments, and other ways to address the disease. National Tuberculosis Day serves to raise awareness of tuberculosis, including the ongoing challenges it creates and the opportunities for preventing and treating the illness.
What is Tuberculosis?
Tuberculosis is a contagious bacterial infection that primarily affects the lungs (pulmonary TB). It can also affect other parts of the body, such as the kidneys, spine, and brain (extrapulmonary TB).
Symptoms of TB may include:
- A persistent cough (lasting three weeks or longer)
- Chest pain
- Coughing up blood or sputum (phlegm)
- Fatigue or weakness
- Weight loss
- Loss of appetite
- Chills
- Fever
- Night sweats
Why Tuberculosis Remains a Serious Health Issue
Despite significant advancements in detecting and treating tuberculosis, it continues to pose a serious public health issue. The disease can easily be spread when an infected person coughs, speaks, or otherwise distributes airborne water droplets. Without proper treatment, TB can lead to serious illness or death.
Other factors that can increase the risk and seriousness of TB infection include:
- Disproportionate impact: TB is more likely to affect vulnerable populations living in poverty. Factors such as malnutrition, poor sanitation practices, overcrowded living conditions, and limited access to health care can all create environments where TB can spread rapidly.
- Treatment challenges: TB treatment requires a long course of antibiotics, typically lasting six months or longer, and adherence to this regimen can be challenging.
- Latent infection: Many people have latent TB infection, which means they are infected with the bacteria but do not actively show TB symptoms and are not contagious. However, latent infection can quickly develop into active disease, especially in people with weakened immune systems.
- Drug resistance: The emergence of drug-resistant forms of TB has created strains of the disease that are more difficult to treat.
Tuberculosis and Co-Occurring Health Conditions
Health conditions that weaken the immune system can make a person more vulnerable to tuberculosis infection. These include diabetes, kidney disease, certain cancers, and people with substance use disorders.
TB is a leading cause of death among people who are HIV positive. HIV and TB form a dangerous synergy, with HIV weakening the immune system and making individuals more susceptible to TB infection and the progression of the disease.
Diagnosis and Treatment
Early diagnosis and treatment are essential to prevent the spread of tuberculosis and ensure successful outcomes.
Diagnosis typically involves a three-step procedure:
- A tuberculin skin test (TST) or blood test (IGRA), which determines if someone is infected with TB bacteria
- Chest X-rays, which are conducted if the skin or blood tests are positive to look for signs of TB disease in the lungs.
- Sputum tests, which are done if the chest X-ray suggests TB disease to confirm the presence of Mycobacterium tuberculosis.
Treatment for TB involves a course of antibiotics, typically lasting six to nine months. Completing the entire course of medication is essential to prevent drug resistance, and directly observed therapy (DOT) may be used to ensure medication adherence.
What You Can Do
- If you experience any tuberculosis symptoms, seek medical attention immediately. Early detection is a crucial factor in stopping the spread of the disease.
- If you have been in close contact with someone who has TB, get tested.
- Practice good respiratory hygiene, such as the “vampire technique” of covering your mouth and nose with the inside of your elbow when coughing or sneezing.