Tuberculosis: Tips and precautions
Tuesday, April 13, 2010
Have you thought of a disease that could get you coughing blood as well as predispose you to other ill health? One is tuberculosis and it continues to be a major health problem worldwide.
In 2008, the World Health Organization (WHO) estimated that one-third of the global population was infected with TB bacteria with the African continent taking a greater proportion of it. Tuberculosis is a chronic infection caused by the bacteria Mycobacterium tuberculosis (and occasionally other variants of Mycobacterium). It usually involves the lungs, but other organs of the body can also be involved. Tuberculosis, often called "TB," is a chronic bacterial infection that can develop after you inhale droplets sprayed into the air (as from a cough or sneeze) by someone infected. This disease has been present from time immemorial and, although its incidence has greatly decreased, it continues to remain a health problem particularly for infants and the very elderly.
How do you know that a person has TB?
Only about 10 per cent of those infected with TB develop the disease. You may not notice any symptoms of illness until the disease is quite advanced.
The first symptoms of an active case of TB may be so commonplace that they are often dismissed as the effects of a cold or flu. The individual may get tired easily, lose appetite, lose weight, lose energy, experience night sweats, feel slightly feverish or cough frequently that may produce bloody sputum. It usually goes away by itself, but about in about half the cases, it will return. For people who have the disease, TB mostly affects the lungs, lymph nodes, genitourinary tract, gastrointestinal tract, bones, joints, the brain and almost all aspects of the body via the blood. In severe cases, there is pleurisy (a sharp pain in the chest when breathing deeply or coughing) or the spitting up of blood. Neither of these symptoms is solely of tuberculosis, but they should not be ignored. TB complications are very serious and shouldn't be ignored.
Risk factors for TB include the following: HIV infection, low socioeconomic status - malnutrition, poor environmental sanitation, alcoholism, crowded and unventilated living conditions "diseases that weaken immune system like AIDS; increasing age" old age; migration from a country with a high number of cases and healthcare workers.
Modes of Spread
TB is caused by a germ that is transmitted from person to person by airborne droplets. Usually this infection is passed on as a result of very close contact, so family members of an infected person are endangered if the person continues to live in the same household and has not undergone proper treatment. (The family should take the precaution of seeing a doctor and getting tested.)
If an individual with active TB coughs or sneezes without covering the mouth and nose, droplets containing the tuberculosis germs are sprayed into the air and may be inhaled by anyone near the person. A tissue should always be used to cover the nose and mouth when coughing, sneezing or spitting, and hands should be washed promptly without exemption. Your risk of contracting the disease varies directly with the frequency of your contacts with people who have TB. Good ventilation and exposure to sunlight decrease the risk of exposure.
If you are exposed to the TB bacterium, the organism may gain entry to your lungs. Often, you are not aware of this exposure in that there are very few, if any, immediate symptoms. The spread of disease generally is limited or contained by your lymph nodes. You might be infected with TB and in some cases the TB disease may or can develop within weeks, months and even years after the initial exposure.
Prevention from acquiring TB
In general, TB is preventable. From a public health standpoint, the best way to control TB is to diagnose and treat people with TB infection before they develop active disease and to take careful precautions with people hospitalized with TB.
Preventive measures include strict standards for ventilation, air filtration, and isolation methods in hospitals, medical and dental offices, nursing homes, and prisons. If someone is believed to have been in contact with another person who has TB, preventive antibiotic treatment may have to be given. General measures such as avoidance of overcrowded and unsanitary conditions are also necessary aspects of prevention.
There are also measures one can take and help protect ourselves and others:
* Keeping the immune system healthy. Eat plenty of healthy foods including fruits and vegetables; get enough sleep, and exercise at least 30 minutes a day most days of the week to keep your immune system in top form.
*Get tested regularly. Experts advise people who have a high risk of TB to get a skin test once a year. This includes people with HIV or other conditions that weaken the immune system, people who live or work in a prison or nursing home, healthcare workers, people from countries with high rates of TB, and others in high-risk groups.
* Consider preventive therapy. If you test positive for latent TB infection, your doctor will likely advise you to take medications to reduce your risk of developing active TB.
* Vaccination: This is one major preventive measure against TB. A vaccine called BCG does help strengthen the immune system. BCG is particularly effective in children. Discuss BCG vaccination with a doctor and ensure to be vaccinated if there is a need for it.
* Finish your entire course of medication. This is the most important step you can take to protect yourself and others from TB. When you stop treatment early or skip doses, TB bacteria have a chance to develop mutations that allow them to survive the most potent TB drugs. The resulting drug-resistant strains are much more deadly and difficult to treat.
* Report to hospital: If a member of the family or somebody close to you is diagnosed as having active TB, then it is very important to get your family and yourself tested. The earlier it is detected, the better and faster the treatment. The dangerous contact time is before treatment. However, once treatment with drugs starts, the sick person is non-contagious within a few weeks.
To help keep your family and friends from getting ill if you have active TB:
* Stay at home. Avoid going to work or school or sleep in a room with other people during the first few weeks of treatment for active TB. Doctors should be able to issue a sick leave for a certain duration if you work (these are the periods that TB is contagious).
* Ensure adequate ventilation. Open the windows whenever possible to let in fresh air. Avoid going in crowded places. Let there be enough ventilation.
* Practise good hygiene: Wash you body regularly, brush your teeth, wear clean clothes and keep your environment tidy and clean.
* Cover your mouth. It takes two to three weeks of treatment before you're no longer contagious. During that time, be sure to cover your mouth with a tissue any time you laugh, sneeze or cough. Put the dirty tissue in a bag, seal it and throw it away. Also, take adequate measures during the first three weeks of diagnosis and treatment as this will help lessen the risk of transmission, remember it is only you that specifically knows you have TB. After the active phase of TB, you can expect to keep your job, to go to school, to stay with your family, and to lead a normal life. However, you must take your medicine regularly to be sure of a cure and to prevent others from being infected.
Diagnosis of Tuberculosis
See a doctor if you don't feel well. Don't wait till your condition gets worse. Ensure that it is a doctor that diagnosed you as having TB because certain diseases like pneumonia, lung abscesses, tumors and fungal infections can look like TB. You are diagnosed as having TB after taking your health history, risk factors, your signs and symptoms, examinations and several tests that will be performed. Some tests that you may undergo are as follows: tuberculin skin-test for the first time, X-ray and laboratory test, eg sputum culture.
The vast majority of people who have TB germs in their bodies do not have an active case of the disease. A positive reaction to the tuberculin test does not mean the person is ill or contagious to others. It means that the germs causing tuberculosis have been or are present in the body, and unless other symptoms are evident, the germs are probably not active. Their doctor may want to treat them to eliminate the germs so that a more serious case of active TB can be prevented.
Undergoing Tuberculosis Treatment
With treatment, your chance of full recovery is very good. Your medications must include several drugs to which the organisms are susceptible. You must take the medication on a regular basis and as prescribed. TB treatment takes long because the disease organisms grow very slowly and, unfortunately, also die very slowly, which is why doctors use multiple drugs to reduce the likelihood of resistant organisms emerging. Often the drugs will be changed or chosen based on the laboratory results. The most common cause of treatment failure is people's failure to comply with the medical regimen. This may lead to the re-emergence of drug-resistant organisms. You must take your medications as directed, even if you are feeling better.
The most important way to keep from spreading TB is to take all your medicine, exactly as told by your doctor or nurse. You should also keep all of your clinic appointments! Your doctor or nurse needs to see how you are doing. You may need another chest X-ray or a test of the sputum you may cough up. These tests will show whether the medicine is working. They will also show whether you can still give TB bacteria to others. Be sure to tell the doctor about anything you think is wrong or you don't understand. If you develop any side effects from medications prescribed to treat tuberculosis such as itching, change in colour of skin, tiredness, or excessive fatigue, inform your doctor immediately.
TB is a deadly disease but fortunately it is largely a preventable disease. TB is spread through the air and can travel a long distance, so PLEASE avoiding public spitting, cover your mouth with a tissue any time you sneeze or cough without exemption. Throw the tissue in a waste bin not on the street. People cannot get infected with TB bacteria through handshakes, sitting on toilet seats, or sharing dishes and utensils with someone who has TB. The most important way to help yourself and avoid spreading TB is to take all your medicine and appointments, exactly as told by your doctor or nurse. Treatment takes a long time, and must not be stopped if the sufferer feels some improvement to prevent resistance which makes it more difficult to treat. Be patient! You will be free!
Reviewed and Approved by the GMDC. Comments, Opinion or Support, write to firstname.lastname@example.org
Author: Emeka Baldeh