Tuberculosis

Introduction:

Tuberculosis is an illness of the lungs. It is a very serious disease. Apart from the lungs, other parts of the body also get affected by it, like the brain, kidneys, and spine. It is a communicable disease which is also known as an infectious disease. It spreads from person to person by air, coughing, sneezing, or by ingesting various contaminated food or water. It is usually transmitted by a bacteria known as Mycobacterium tuberculosis.

Death can occur by tuberculosis without prolonged treatment. According to the reports, Tuberculosis has become one of the deadliest diseases in the world and it is causing 1.2 million deaths every year.

History reveals that this disease has been around for most of the time on the surface of the earth and sometimes it has become deadly. Many researchers have found traces of tuberculosis in Egypt around 3000 BC.

Stages:

Tuberculosis does not affect someone right away, but the infection passes through different stages. Symptoms are different in each stage of infection.

1. Primary TB Infection:

This occurs when bacteria enter into the body for the first time.
The immune system tries to kill all the germs in the body, most of the time germs get diminished but, in some cases, some germs remain alive.
Most of the time, primary TB infections are asymptomatic and later become active in the form of Latent TB Infection. There are no symptoms at first but, sometimes symptoms arrive like:

• Fever
• Tiredness
• cough

2. Latent TB Infection:

The primary TB infection is followed by another infection, known as latent TB infection. In this infection, the body’s immune system forms a layer around the lung tissues to protect the lungs from germs. In some patients, germs survive but they remain inactive. If anyone has a Latent TB infection, he cannot transmit it to other people. In other words, this infection is not transmittable. In this infection, no symptoms appear but the infection is alive and can become active someday.

3. Active TB infection:

Active TB infection occurs after the latent TB infection or primary TB infection. It happens when the immune system cannot control the germs and these germs spread and cause tuberculosis by infecting many parts of the body, particularly the lungs. Active TB Infection can be drug resistant in some cases and a lot of medications do not work against it.

Symptoms of Active TB Infection appear with time and these, usually, become more dangerous in a few weeks. The following symptoms appear in most patients:

• Cough.
• Coughing up blood or mucus.
• Fever.
• Chills.
• Chest pain.
• Night sweats.
• Loss of appetite
• Pain with breathing or coughing.
• Weight loss.
• Generalized body aches
• Fatigue

4. Active TB disease outside the lungs (extrapulmonary tuberculosis):

TB infection also affects other parts of the body other than the lungs. The symptoms usually remain the same as they were at the lungs. When the larynx, which is known as the voice box gets infected by tuberculosis. its symptoms appear to be like the symptoms of the lungs. A few symptoms of extrapulmonary tuberculosis are the following:

• Intermittent Fever.
• Tiredness.
• Chills.
• Weight loss.
• Pain near the site of infection.
• Night sweats.

Outside the lungs, TB disease affects the following body parts:

• Kidneys.
• Genitals.
• Fluids around the spinal cord and brain.
• Muscles of heart.
• Lymph nodes.
• Liver.
• Joints of, usually, bone.
• Outer skin.
• larynx.

Tuberculosis Transmission:

Tuberculosis is usually transmitted by germs through the air. When someone coughs or sneezes, he releases the germs in the form of a few droplets in the atmosphere. And when someone breathes these germs, he gets infected by this contagious infection.

Tuberculosis cannot be caught easily. Anyone can get infected by it, if he/she remains with the infected person for so long. One can get TB if anyone of his family members, coworkers, or friends have this disease because he spends most of his time with them. TB can also be transmitted to a person who works in a place where TB is common, like nursing in a hospital. TB is also common in those people who smoke daily.

An interesting piece of information is that a well-immunized body does not get affected by TB unless it has gotten diseases that weaken the immune system. According to the research, in the year 2022, there were 13.1 cases of tuberculosis per 100,000 population in Alaska and it is the highest rate of tuberculosis in any state. It so happens because of the presence of other serious diseases. The most common factors due to which TB can affect the body rapidly are written below:

• AIDS and HIV.
• Various diseases of the kidney.
• Diabetes.
• Cancer treatments.
• Medications that are given to patients for organ transplantation.
• Low body weight and poor nutrition.
• Different kinds of cancers such as head or neck.
• Smoking tobacco.
• Exposure to air pollution.
• Poverty

TB cannot be transmitted in many manners because the bacteria which causes this disease does not live on the surface. These are as follows:

• Shaking hands with the infected person
• Using an infected toilet
• Sharing drinking glasses
• Touching various infected surfaces

Diagnosis of Tuberculosis:

Tuberculosis can be examined through various processes and tests. Examination of this disease is a very difficult and complex process. So, doctors usually look at the living standards of the patient and other diseases to which the patient is exposed or by which the patient is infected. Two types of tests are conducted by doctors to examine the TB in a patient.

1. Skin Test:

This test is also known as the Mantoux test. In this test, a solution of TB-causing bacteria is injected into the skin’s upper layer of the arm. The patient is again examined after two or three days. If the injection site was swollen and protruded, then the patient has an infection of tuberculosis. Sometimes, this test can be wrong and can show false positives.

2. Blood Test:

This blood test is commonly known as Interferon-Gamma Release Assays (IGRAs). This test is more accurate. This test is done in a lab after taking blood from a person. This test usually measures the response of the body to the bacteria of the body, known as Mycobacterium Tuberculosis.

3. Diagnostic Tests:

If initial tests were positive, then further tests are required to diagnose the type of tuberculosis known as diagnostic tests. These tests also help determine the type of TB bacteria and find the best antibiotics for it. The following ways are used:

1. X-ray: Chest X-Ray is used to find signs of TB in the lungs.
2. Computerized Tomography (CT) Scans: CT scans are used in the diagnosis of TB in the spine and are also used if the pictures of X-rays of the lungs are unclear.
3. Magnetic Resonance Imaging (MRI): MRI is done when bacteria of TB spread to many parts of the body like the brain and spine.
4. Molecular Tests: These tests can be used to detect the nature of bacteria. So, effective antibiotics can be used against it.
5. Acid-fast bacillus (AFB) tests: These tests, most of the time, are used to detect TB bacteria I.e., Mycobacterium Tuberculosis in sputum. Sputum is a kind of mucus that usually comes up on coughing.

Treatment:

TB is still a deadly disease, in many countries, causing many deaths. Its treatment is a must and needs full attention. In its treatment, patients are given instructions to take medicines in a particular way. The drugs take a long time to kill disease-causing bacteria. So, its treatment takes more than 6 months.

• If a patient has latent TB, then he is given medications that are helpful to kill all the germs. So, they cannot become active. These drugs are taken for more than 9 months
• Many drugs are used to treat active TB like isoniazid, and rifampin. These drugs should be taken till the end of all doses because some germs remain alive and become drug resistant.

Active TB is very contagious. So, a process is used to ensure that the patient is taking drugs at the proper time. This process is known as Direct Observed Therapy (DOT). In this process, a specialized and trained worker is responsible for giving medication doses to the patients on time and watching them swallow them.

In the United States of America the year 1970, the death rate due to tuberculosis was 5,217 and in the year 2020, it decreased to only 600 deaths. It was all due to the treatment offered by the doctors. This research shows the control and treatment of Tuberculosis in a better way in the United States of America and in the rest of the world.

Prevention:

Avoiding people who are infected by TB is the best way to prevent TB infection.

Identifying and learning about the type of TB and treating it in that manner is a very big step for preventing TB from spreading.

Patients with active TB must limit their meetings with groups and gatherings because it spreads from them.

Do wear masks or cover your mouth while coughing or sneezing.

Do not travel to the places where TB is common.

Vaccine for Tuberculosis:

In many countries, tuberculosis is common so they vaccinate their children or infants by Bacille Calmette-Guerin (BCG). This vaccine is not proof of protection from the infection of TB, but it is usually recommended to those children who are living in a region where tuberculosis is common, or whose family members have active TB.