Tuberculosis is one of the leading causes of death worldwide. According to the WHO, tuberculosis casualties increased at an alarming rate in the 1980s, and became the 13th leading cause of death. In Spain, one in seven individuals are exposed to Tuberculosis. However, the introduction of antibiotics and the improvement of living conditions caused tuberculosis to decrease in developed countries. But it’s still not enough!
The World Health Organization reports that in 2020, more than 10 million people developed tuberculosis, and 1.5 million died from the disease. Most of the people were from Asia, and others from all over the world. It is true that antibiotics are useful to cure the disease, but they are not always the panacea we are looking for, and they are still ineffective in some cases. Read on to learn about future trends in tuberculosis.
Tuberculosis (TB) and its consequences
Tuberculosis is a contagious infection that frequently affects the lungs . It can also potentially affect other parts of the body, such as the spine and the brain. It is caused by inhaling a bacterium known as Mycobacterium tuberculosis. It is true that there are other bacteria, such as Mycobacterium bovis, that also cause the disease (through ingestion of unpasteurized milk), although they are much less frequent. Thus, as tuberculosis is a contagious disease, a person who comes into contact with an individual suffering from tuberculosis is likely to develop the disease. Having tuberculosis does not mean that a person will get sick, but the following cases may occur:
Primary tuberculosis infection is the initial phase of the disease, in which bacteria enter the human body. Very few people experience any respiratory symptoms at first. Healthy individuals with a robust immune system do not show any signs in this phase. According to the Center for Disease Control and Prevention (CDC), primary tuberculosis is the earliest stage of tuberculosis, followed by latent tuberculosis.
Latent tuberculosis is a disease state in which the person does not show any signs or symptoms. In addition, on a chest x-ray no particular damage appears. However, another test, such as a skin prick test or a blood test, could put us on the track of an M. tuberculosis infection.
A person with active tuberculosis will show symptoms of tuberculosis. The person will have a cough with phlegm, fever, chills, fatigue, loss of appetite and weight loss. These symptoms may go away after a while, but there is a high chance that they will come back.
How does tuberculosis appear in a person?
As we have said before, latent tuberculosis would not show any signs of disease. However, active tuberculosis may present with one or more of the following symptoms : coughing up blood, a cough that lasts three weeks, chills, fever, fatigue, chest pain, and loss of weight and appetite
Why is tuberculosis spreading so fast?
Tuberculosis is the result of inhaling the bacteria, so contact with other people would spread the disease. The bacteria do not survive on surfaces, so a person can get the bacteria from exposure to a cough or sneeze from an infected person, but not from contact with surfaces (fomites).
Also, people who have a weak immune system are more likely to develop active tuberculosis. People with other medical conditions such as AIDS, HIV, diabetes (especially if it is longstanding and poorly controlled), cancer and kidney disease have a higher proportion of being affected by Tuberculosis. In addition, people addicted to tobacco and drug abuse (especially injectables) are more likely to contract tuberculosis infection.
Diagnosis is complicated!
The diagnosis of tuberculosis can be a complex process . There are many factors that can make this diagnosis complex, starting with the history of exposure. If you’ve been exposed to someone with the disease, certain screening tests are done to confirm (or rule out) TB infection and proceed with treatment, as appropriate.
But perhaps one of the most challenging aspects is that, as we mentioned, latent tuberculosis does not show any signs or symptoms. Therefore, screening tests help identify whether there is a tuberculosis infection. The tests that show if there is a tuberculosis infection are of the following types:
In the skin test, healthcare personnel inject a small amount of a protein into a person’s arm. After two or three days, if a 5mm to 15mm welt appears on the skin, the result is considered positive. Otherwise, if nothing shows up, the person does not have a TB infection. This test is known as mantoux.
Although this test is not perfect, a person who has received the tuberculosis vaccine may not show any signs of tuberculosis infection.
Following the skin test, the doctor may use a blood test below. Based on the result of the blood test, a person can be diagnosed with tuberculosis.
After obtaining positive results in the previous skin and blood tests, the doctor will proceed to perform a chest x-ray. If the chest x-ray shows the presence of lesions in the lungs, this is another possible sign of tuberculosis infection.
There is always the possibility that a person’s TB infection is latent, not allowing doctors to identify it on an X-ray. Therefore, due caution and screening tests are necessary to identify tuberculosis infection. That’s why doctors also use other tests when needed, such as lung biopsy, bronchoscopy, and CT scan.
Tuberculosis treatment is exceptional
Although most bacterial infections are treated by taking antibiotics, tuberculosis is an exception. People who are diagnosed with active TB disease have to take 6 to 9 months. If a person does not follow proper treatment, it can happen that tuberculosis returns after a while. Therefore, it is essential to follow the proper course of medication.
A person can develop a TB infection even if they take the medication for some reason. Normally, when a person lives in a place where he is in contact with people who have different diseases such as HIV or others, he has more chances of prolonging tuberculosis.
References:
Billo, N. E. (2016). Costes de la TB y la MDR-TB: ¿es hora de convocar un Comité de Emergencia de la OMS sobre la TB? The International Journal of Tuberculosis and Lung Disease, 20(4), 427. https://doi.org/10.5588/ijtld.16.0104
Exposure to TB. (2016, March 21). Centers for Disease Control and Prevention. https://www.cdc.gov/tb/topic/basics/exposed.htmKoritskaya, I., y Pukhlik, B. (1994). La tuberculosis y las enfermedades alérgicas. Tuberculosis y enfermedades pulmonares, 75, 22. https://doi.org/10.1016/0962-8479(94)90762-5ÂNall, R. M. (2021, 12 de noviembre). La tuberculosis. Healthline. https://www.healthline.com/health/tuberculosis#takeawayÂTuberculosis (TB). (2017, 17 de enero). WebMD. https://www.webmd.com/lung/understanding-tuberculosis-basicsÂTuberculosis. (2021, October 14). World Health Organization: WHO. https://www.who.int/en/news-room/fact-sheets/detail/tuberculosisÂ‌Vectorjuice (s.f.). Tuberculosis abstract concept vector illustration. world tuberculosis day, mycobacterium infection, diagnostics and treatment, infectious lung disease, contagious infection abstract metaphor Free Vector [Imagen]. Freepik. https://www.freepik.com/vectorjuiceÂWorld Health Organization. (‎2012)‎. Tuberculosis. En Bugs, drugs and smoke : stories from public health (pp. 97- 117). World Health Organization. https://www.who.int/about/bugs_drugs_smoke_chapter_6_tuberculosis.pdf‌Â
