Tuberculosis (TB) is a bacterial infection spread through inhaling tiny droplets from the coughs or sneezes of an infected person. It is a serious condition, but can be cured with proper treatment. TB mainly affects the lungs. However, it can affect any part of the body, including the glands, bones and nervous system.
WHAT TYPE OF TUBERCULOSIS IS THE MOST CONTAGIOUS?
The type that affects the lungs is the most contagious form. It usually spreads after prolonged exposure to someone with the illness. For example, someone who lives in the same house as an infected person is more susceptible to the illness.
In most healthy people, the immune system (the body’s natural defense against infection and illness) kills the bacteria, causing you to have no symptoms.
There are two types of TB:
- Active TB: If the immune system fails to kill or contain the infection, it can spread within the lungs or other parts of the body and symptoms will develop within a few weeks or months.
- Latent TB: Sometimes the immune system cannot kill the bacteria, but manages to prevent it from spreading throughout the body, meaning you will not display any symptoms, but the bacteria will remain in your body. Latent TB has the potential to develop into an active TB infection later on, particularly if your immune system becomes weakened.
TB is not spread by:
- Sharing drinking containers or eating utensils
- Cigarettes, sharing food
- Shaking someone’s hand
- Touching bed linens or toilet seats
- Sharing toothbrushes
- Saliva from kissing
SYMPTOMS OF TUBERCULOSIS
- A cough with thick, cloudy, and sometimes bloody mucus from the lungs (sputum) for more than 2 weeks
- Fever, chills, and night sweats
- Fatigue and weakness
- Loss of appetite and unexplained weight loss
- Shortness of breath and chest pain
TREATMENT OPTIONS AVAILABLE FOR TUBERCULOSIS
- Medication therapy: Several antibiotics are used at the same time to treat active tuberculosis (TB) disease. For people who have multidrug-resistant TB, treatment may continue for as long as 24 months. These antibiotics are given as pills or injections. For active TB, there are different treatment recommendations for children, pregnant women, people who have HIV and TB, and people who have drug-resistant TB.
Directly observed therapy (DOT)
This means visits with a health professional who watches you every time you take your medicine. A cure for TB requires you to take all doses of the antibiotics. These visits ensure that people follow medicine instructions, which is helpful because of the long treatment course for TB.Experts recommend using one of the following medicine to kill the TB bacteria and prevent active TB:
- The standard treatment is isoniazid, which is taken for 9 months. For people who cannot take isoniazid for 9 months, sometimes a 6-month treatment program is followed.
- Alternatively, treatment with rifampin for 4 months is acceptable, especially for people who have been exposed to bacteria that are resistant to isoniazid.
- Taking two antibiotics once a week for 12 weeks to kill the TB bacteria.For this treatment, health professional witnesses you take each dose of antibiotics. Taking every dose of antibiotic helps prevent the TB bacteria from getting resistant to the antibiotics. The combinations of antibiotic include isoniazid and rifapentine or isoniazid and rifampin.
BCG, or bacille Calmette-Guerin, is a vaccine for tuberculosis (TB) disease. Many foreign-born persons have been BCG-vaccinated. BCG is used in many countries with a high prevalence of TB to prevent childhood tuberculous, meningitis and miliary disease. However, BCG is not generally recommended for use in the United States because of the low risk of infection with Mycobacterium tuberculosis, the variable effectiveness of the vaccine against adult pulmonary TB, and the vaccine’s potential interference with tuberculin skin test reactivity. The BCG vaccine should be considered only for very select persons who meet specific criteria and in consultation with a TB expert.
- History taking: Getting an accurate history is important in diagnosing and treating TB. Like any disease, early intervention and treatment is very important.
- Physical examination: The physical exam looks for signs of TB. A doctor uses a stethoscope to listen to your breathing for sounds that indicate a problem in your lungs. The doctor also will look for signs of a TB infection in parts of the body other than your lungs (extrapulmonary TB).
Sputum culture and cytology
Testing mucus from the lungs (sputum culture) is the best way to diagnose active TB. But a sputum culture can take 1 to 8 weeks to provide results. Sputum cytology examines a sample of sputum (mucus) under a microscope to determine whether abnormal cells are present. Sputum is not the same as saliva. Sputum is produced in the lungs and in the airways leading to the lungs. Sputum has some normal lung cells in it. Sputum cytology may be done to help detect certain noncancerous lung conditions. It may also be done when lung cancer is suspected.
A chest X-ray usually is done if you have:
- A positive tuberculin skin test (also called a TB skin test, PPD test, or Mantoux test).
- Symptoms of active TB, such as a persistent cough, fatigue, fever, or night sweats.
- An uncertain reaction to the tuberculin skin test because of a weakened immune system, or to a previous bacille Calmette-Guerin (BCG) vaccination.
Rapid blood test
Rapid blood tests help detect latent TB. They can help diagnose TB when results from a tuberculin skin test are uncertain. These tests also can tell if a person who has had a BCG vaccination has a TB infection. A rapid test requires only one visit to the doctor or clinic, instead of two visits as required for the tuberculin skin test. Rapid blood tests are also called interferon-gamma release assays (IGRAs).