Tuberculosis (TB) - Symptoms, Diagnosis, Prevention & Treatment
Health Education

Tuberculosis (TB)

Authored by DesiMD Doctor on 21 Mar 2013 - 16:29.

Tuberculosis (TB) is widespread in India with over 2 million people infected annually and about 330,000 deaths attributed to this disease annually (1). Therefore, it is important to recognize signs and symptoms of tuberculosis, so that you can seek immediate treatment and protect people around you. In this article we provide basic information on TB, that we think all people need to be empowered with.

Tuberculosis is caused by bacteria called Mycobacterium Tuberculosis. These bacteria are particularly resistant to various antibiotics and some detergents.

Scanning Electron microscopy picture of Mycobacterium tuberculosis (Credit: Janice Haney Carr)

It is important to understand that tuberculosis infection occurs with different severity.

Latent TB: Majority of the population in countries like India have a sleeping infection, called “latent tuberculosis”, where the person has been exposed to and infected by tuberculosis bacteria but the immune system suppresses the bacteria. Latent TB is not contagious and people may never manifest symptoms in their life, but having latent TB does mean that the person has a higher risk of developing active tuberculosis infection during their life (about 5%).
 

Active TB is an infection by the tuberculosis bacteria in almost any part of the body, but most commonly in the lungs. Symptoms of active TB are often slow to appear and progress over several months. These symptoms commonly include fever, night sweats, weight loss, and fatigue. Additionally, pulmonary tuberculosis (tuberculosis infection of the lungs) often manifests with a chronic, productive cough. Tuberculosis can also occur outside of the lungs such as in the lymph glands under your skin, intestinal tract, or in the fluid around the spine/brain– these may be extensions of a lung infection or a separate infection of their own.
 

Tuberculosis

Image showing the main sites affected by extrapulmonary tuberculosis (Credit: Mikael Haggstrom)

Because the symptoms of tuberculosis overlap with symptoms of many other diseases, tests are needed to help make the diagnosis. Make sure you also bring up your concern for tuberculosis when you see a health professional. Although a skin test (called the mantoux or PPD test) is widely used to diagnose latent and active tuberculosis, the test can sometimes be falsely positive in people who received BCG (tuberculosis) vaccine. A new blood-test (QuantiFERONR- TB Gold Test) was recently developed which is not affected by the BCG vaccine and is offered in some parts of the world such as the United States. Tests for active pulmonary tuberculosis include analysis of the sputum (plus or minus a skin or blood test), and an x-ray of the lungs.

The BCG vaccine, given in many countries in the world including India, offers some protection for tuberculosis from spreading through the body and into the central nervous system if you contract pulmonary TB. However, it does not reduce your overall risk of contracting tuberculosis infection. It also offers small or partial protection for other medical conditions such as leprosy and recurrent bladder cancer. Although its protection is far from perfect, the vaccine in itself is generally very safe. There are currently strong research efforts to find a new, more effective vaccine that offers more complete protection against contracting tuberculosis.


In countries such as India, where tuberculosis is prevalent, treatment is targeted for active tuberculosis with several months of antibiotics.


Latent tuberculosis is generally not treated in India because the treatment is long, there is a high rate of resistance to the primary treatment in countries like India, treatment does not eliminate the bacteria completely, and you are likely to get re-exposed to tuberculosis very quickly leading to redevelopment of latent tuberculosis.

 

Exceptions where you might need treatment include the following conditions:

  • Suppressed immune system (example: taking long-term steroid medicines or if you have HIV/AIDS).
     
  • Children less than 2 years of age who live with someone with active pulmonary tuberculosis should also be treated.
     
  • The course of treatment for active tuberculosis is several months of a combination of medicines and requires much effort as the medicines can have side effects; most commonly inflammation of the liver, and you should not drink alcohol when on these medicines. But at the same time, it is extremely important not to miss any doses because that will give the bacteria time to develop resistance to the medicines. In fact, there are emerging strains of resistant tuberculosis in the world that require second-line medicines or are even untreatable. Many parts of the world, including India, are using a program for directly observing therapy to assist with compliance.
     
  • If you have exposure to person with TB or have any symptoms or concerns please discuss with your health care professional

 

Pulmonary tuberculosis is very contagious and passed through the air so if you develop these symptoms with cough, take utmost precaution to stay away from crowded public places (wearing a mask when doing so), even keep a distance from family members until you test negative or get treated for tuberculosis. You should seek medical attention as soon as possible – not only to catch the infection before it progresses, but to protect your loved ones and people around you.

*Disclaimer This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.