Tuberculosis (TB) is a lung disease caused by a bacteria (Mycobacterium Tuberculosis). This bacteria can also attack other parts of the body (Extrapulmonary TB). TB can affect anyone, at any age, of any socioeconomic status.

TB is an old disease, “recorded as far back in history as the Old Testament of the Bible. Hippocrates wrote about tuberculosis in Greek literature around 460 BC, and Shakespeare mentioned it in Macbeth.” (https://source.colostate.edu/tuberculosis-innovation/) As time goes on, tuberculosis is becoming more difficult to treat due to drug-resistant strains. After all of these years, tuberculosis continues to pose a significant health threat around the world.

Tuberculosis is spread in the air when someone with TB talks, coughs, or sneezes. Anyone in the surrounded area may become affected by inhaling the bacteria. Many people mistake the symptoms for a bad cold and it people may be misdiagnosed with pneumonia.

Incidence

Tuberculosis can affect anyone of any age, race, or sex. It affects the young and the old. TB is much more prevalent than people realize and is more prevalent in developing countries. It remains one of the top 10 causes of death.  According to the Centers for Disease Control and Prevention, over 10 million people worldwide, were diagnosed with TB; and over 1 million people died from the disease.

SymptomsTuberculosis: Causes, Symptoms, Diagnosis, Risk Factors, Treatments

  • Persistent Cough lasting more than 3 weeks
  • Bloody mucus when coughing (hemoptysis)
  • Chest pain
  • Weight loss
  • Fatigue
  • Fever
  • Loss of appetite
  • Night sweats

Diagnosis

Diagnosis begins with a routine examination. If you have been exposed to anyone with suspected tuberculosis, the doctor will order testing quickly. Diagnostic tests to diagnose TB include:

  • Chest x-ray
  • Skin test (PPD)
  • Blood test
    • Usually ordered following a positive PPD skin test
  • Sputum culture

Two Types of Tuberculosis

There are two types of tuberculosis; Latent Tuberculosis and Active Tuberculosis disease.

Latent TB occurs in people who have been exposed to and contracted TB but have no symptoms. “About one-quarter of the world’s population has latent TB” (http://www.who.int/mediacentre/factsheets/fs104/en/). Typically, these people have immune systems that are able to fight the bacteria, as such, they never develop symptoms. People with Latent Tuberculosis cannot spread the TB bacteria.

Tuberculosis disease occurs when people are exposed to the TB bacteria which begins to multiply within the body causing the person to eventually become symptomatic. Early after exposure, there may be no symptoms (Latent TB) and it may later become TB disease. Therefore, anyone with TB diagnosis, even latent, are treated to prevent them from developing the disease.

It is important to note that not everyone develops TB right away. People with latent TB can remain symptom-free for years before it becomes active (usually triggered by an illness and a weakened immune system).

Risk Factors

  • Exposure to anyone with TB
  • Residing in countries with high incidence of TB
  • Weak immune system 
         infant/children, elderly, HIV +
  • Certain medical diagnosis
    • Diabetes
    • Organ transplant recipients
    • Cancer
    • Kidney disease
    • Those receiving specialized treatments for certain diseases (like Cancer Chron’s disease, or organ transplant recipients)
  • Homeless persons
  • Recreational drug users
  • HIV infection (https://www.cdc.gov/tb/statistics/default.htm)
  • Working in a high-risk facility (hospital/nursing facility, prison, shelter)
  • Previously, improperly treated TB

Treatment

Tuberculosis is treated with medication (Isoniazid (INH), Rifampin (RIF), Rifapentine (RPT), or Ethionamide (Trecator) are the most common drugs used) for an extended period of time. It is important that people diagnosed with TB take their medication as prescribed and in its entirety; not stopping when they feel better. Symptoms may go away, but if the disease is still active, the bacteria will begin to multiply and the symptoms will return. The more often that this occurs, the more resistant the bacteria will become, making treatment difficult. Without proper treatment, tuberculosis can be deadly.

Tuberculosis is a disease that has been around for a long time. However, new treatments have not emerged for many years in spite of the fact that the World Health Organization still recognizes the disease as a threat.  The good news is that some institutions, such as Colorado State University, are now working on new innovations to treat this disease.

If you think that you have been exposed to TB, don’t hesitate to contact your doctor to discuss testing and possible treatment.

If you plan to visit a region where TB is more prevalent, ask your doctor about receiving the BCG vaccine.

The information in this article is to be used for informational purposes only. It is NOT to be used in place of, or in conjunction with, professional medical advice. Anyone with questions regarding this or other medical issues discussed on this site must consult their physician for further information and treatment.

Resources:
Centers for Disease Control and Prevention https://www.cdc.gov/tb/topic/treatment/default.htm
Medline Plus https://medlineplus.gov/tuberculosis.html
Colorado State University https://source.colostate.edu/tuberculosis-innovation/
World Health Organization http://www.who.int/mediacentre/factsheets/fs104/
The National Institutes of Health https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0024668/
https://www.tbfacts.org/tb-statistics-south-africa/
American Lung Association http://www.lung.org/assets/documents/research/tb-trend-report.pdf
Cleveland Clinic http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/infectious-disease/tuberculosis/
The University of California, San Fransisco HIV In Site http://hivinsite.ucsf.edu/InSite?page=kb-05-01-06
Bill and Melinda Gates Foundation https://www.gatesfoundation.org/What-We-Do/Global-Health/Tuberculosis

   
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