A Weekly column prepared by Dr. Balwant Singh’s Hospital Inc
Dr Soumyaroop Dash – MD, DNB (Consultant Gynaecologist & Obstetrician)
What is TB?
Tuberculosis (TB) is a disease caused by bacteria called Mycobacterium tuberculosis. The bacteria usually attack the lungs. But, TB bacteria can attack any part of the body such as the kidney, spine, and brain. If not treated properly, TB disease can be fatal.
What is latent TB infection?
In most people TB bacteria and become infected, the body is able to fight the bacteria to stop them from growing. The bacteria become inactive, but they remain alive in the body and can become active later. This is called latent TB infection. People with latent TB infection:
* have no symptoms
* don’t feel sick
* can’t spread TB to others
* usually have a positive skin test reaction
* may develop active TB disease if they do not receive treatment for latent TB infection.
Many people who have latent TB infection never develop active TB disease. In these people, the TB bacteria remain inactive for a lifetime without causing disease. But in other people, especially people who have weak immune systems, the bacteria can become active and cause TB disease.
What is active TB disease?
TB bacteria become active if the immune system can’t stop them from growing. The active bacteria begin to multiply in the body and cause active TB disease. The bacteria attack the body and destroy tissue. If this occurs in the lungs, the bacteria can actually create a hole in the lung. Some people develop active TB disease soon after becoming infected, before their immune system can fight the TB bacteria. Other people may get sick later, when their immune system becomes weak for another reason.
Babies and young children often have weak immune systems. People infected with HIV, the virus that causes AIDS, have very weak immune systems.
Symptoms of TB depend on where in the body the TB bacteria are growing. TB bacteria usually grow in the lungs. TB in the lungs may cause symptoms such as:
* a bad cough that lasts three weeks or longer
* pain in the chest
* coughing up blood or sputum (phlegm from deep inside the lungs)
Other symptoms of active TB disease are:
* weakness or fatigue * weight loss
* no appetite * chills
* fever * sweating at night.
How can I get tested for TB?
You should get tested for TB if:
* You have spent time with a person known to have active TB disease or suspected to have active TB disease;
* You have HIV infection or another condition that puts you at high risk for active TB disease;
* You think you might have active TB disease;
* You are from a country where active TB disease is very common (most countries in Latin America and the Caribbean have a very high incidence of TB)
* You have spent time in a homeless shelter or prison where TB disease is more common;
* You inject illegal drugs.
The TB skin test
The TB skin test may be used to find out if you have TB infection. You can get a skin test at the health department or at your doctor’s office. A health care worker will inject a small amount of testing fluid (called tuberculin or PPD) just under the skin on the under side of the forearm. After two or three days, you must return to have your skin test read by the health care worker. You may have a swelling where the tuberculin was injected.
The health care worker will measure this swelling and tell you if your reaction to the test is positive or negative. A positive reaction usually means that you have been infected by someone with active TB disease.
What if I have a positive skin test for TB?
If you have a positive reaction to the TB skin test, your doctor or nurse may do other tests to see if you have active TB disease. These tests usually include a chest x-ray. It may also include a test of the phlegm you cough up. Because the TB bacteria may be found somewhere other than your lungs, your doctor or nurse may check your blood or urine, or do other tests. If you have active TB disease, you will need to take medicines to treat the disease
What if I have been vaccinated with BCG?
BCG is a vaccine for TB. It is often given to infants and small children in countries where TB is common. BCG vaccine does not always protect people from getting TB.
* If you were vaccinated with BCG, you may have a positive reaction to a TB skin test. This reaction may be due to the BCG vaccine itself or due to infection with the TB
bacteria.
How is active TB disease treated?
There is good news for people with active TB disease! It can almost always be treated with medicine. But the medicine must be taken as the doctor or nurse tells you.
If you have active TB disease, you will need to take several different medicines. This is because there are many bacteria to be killed. Taking several medicines will do a better job of killing all of the bacteria and preventing them from becoming resistant to the medicines.
Having active TB disease should not stop you from leading a normal life. When you are no longer infectious or feeling sick, you can do the same things you did before you had active TB disease. The medicine that you are taking should not affect your strength, sexual function, or ability to work. If you take your medicine as your doctor or nurse tells you, the medicine should kill all the TB bacteria. This will keep you from becoming sick again.
Next week we will conclude this article by focusing on the steps that we should take to stop TB from spreading.
