- Persistent cough
- Coughing up blood
- Chest pain
- Weight loss
- Night sweats
- Enlarged lymph glands
Tuberculosis, or TB as it is commonly known, is an infectious disease that usually attacks the lungs, although it can affect almost any organ, including the kidneys, brain, skin, bones (particularly spine), eyes and lymph glands.
Although improved living standards in the first half of this century had begun to reduce the impact of tuberculosis, it was the widespread use of very effective drugs in the 1950s which hastened the rapid decline of this disease in Australia.
Now the disease is much rarer, although numbers have risen recently, so much so national newspapers are starting to report on the situation, people are starting to ask questions about the topic. In our First Aid training courses we talk about infectious diseases especially when coming to the aid of a person who is in need of first aid, and the type of precautions you can take to minimise the risk of exposure.
Tuberculosis kills around three million people each year worldwide, and is one of the most common epidemic diseases in developing countries, where malnourished people live in crowded unsanitary conditions.
What causes tuberculosis (TB)?
Tuberculosis (TB) is caused by bacteria. Millions of the tubercle bacilli live in the sputum of infected people. When these infected individuals cough or sneeze, the resulting shower of droplets is breathed into the lungs.
Tuberculosis (TB) can occasionally be caused by drinking the unpasteurized milk of cows with tuberculosis in their udders, but the slaughter of infected cattle, plus testing and heat treatment of milk, have practically eliminated this source of contamination.
In most people, the spots of inflammation in the lungs caused by tuberculosis heal of their own accord, but in a small number of cases, the bacilli multiply and are absorbed into the lymph glands.
Some bacilli may then migrate into the bloodstream and rapidly spread around the whole body, resulting in what is known as miliary tuberculosis. Bacteria may also go into a dormant state, to be reactivated many years later
How is tuberculosis diagnosed and treated?
The incubation period for tuberculosis can vary from a few weeks to many years, as the infection can lie dormant in the body. Miliary TB or tuberculous meningitis (infection of the brain and spinal cord) are most common in children, while with adolescents and adults, the disease usually affects the lungs.
A child may just appear generally unwell, but the initial diagnosis in adults is typically indicated by outward symptoms: tiredness, night sweats, fever and weight loss, and (if the lungs are affected) coughing, chest pain, breathlessness, and phlegm, which is flecked with blood.
Diagnosis is confirmed by a number of hospital tests, while treatment is with a combination of antibiotics.
When should I see my doctor?
You should see your doctor straight away if you have any of the symptoms listed, especially if you are coughing up blood.
Your doctor will make a thorough examination and arrange for the hospital to carry out a number of tests, including analysis of the sputum for tubercle bacilli. A skin test with tuberculin (a product of the tubercle bacilli) will reveal if there has been exposure to infection. X-rays will show shadows on the lungs in the areas affected by TB, and may indicate whether the disease has spread to other organs.
Drug treatment varies, but usually the doctor will prescribe a combination of three different antibiotics, which must be taken simultaneously for around two months to overcome the problem of resistance to any one drug. This is followed by a course of two antibiotics, sometimes for up to a year.
The doctor will want to trace all people the patient has been in contact with, so they can be tested and offered treatment. The patient will also be monitored for any possible adverse effects of the drugs, especially on the liver.
What can I do to avoid tuberculosis?
Vaccination is available, if a tuberculin test shows no immunity to the disease. This gives protection for at least 10 years. Vaccination is rarely required for short visits abroad, but adults planning to work for a long time in a Third World country should be tested and, if they have no immunity, opt for vaccination.
Is tuberculosis dangerous?
If swiftly and properly treated, patients almost always make a full recovery. However, if left undiag-nosed, tuberculosis can cause disabling illness and eventually death.
The following are particularly susceptible to tuberculosis:
- Those who have undergone a gastrostomy (total or partial removal of the stomach)
- Those with leukaemia or other conditions associated with a defect in the immune system.