Tuberculosis- Causes, Symptoms, Treatment, Risk Factors

Dr. Ajay Bedi
MBBS, DA
Founder, Director & Anaesthesiologist, EDMC
Hony. Secretary, Delhi Medical Association

So many people remember TB from the famous government ads from the last decade where they insisted a doctor’s checkup when coughing goes beyond a certain number of weeks. But you may be surprised to know, this seemingly coughing related disorder, after COVID, is the biggest infectious killer in the world!

WHO data says every year around 10 million people get infected and around 1.5 million people lose their life, to this treatable disease. Let’s explore this pressing global (and national) health issue, as Understanding its transmission and treatment is crucial for effective management and possible prevention.

What is the Tuberculosis?

Tuberculosis is an infectious disease and a major illness caused by bacteria transmitted through the air when infected individuals cough, sneeze, or spit. TB most commonly targets the lungs but it can affect other organs as well.

Another curious fact, WHO estimates that approximately a quarter of the entire world’s population has encountered TB bacteria. But then how does transmission occur? When you have close contact with infected individuals, especially in crowded or poorly ventilated position.

How is TB Transmitted?

At the heart of TB’s spread lies a simple yet profound act – breathing. When an individual with active pulmonary TB coughs, sneezes, talks, sings, or even laughs, microscopic droplets containing the TB bacteria are expelled into the air. These invisible projectiles, carrying the disease’s payload, can then be inhaled by those in close proximity.

What are the Symptoms of Tuberculosis (TB)?

Please Note : While understanding symptoms is good for assessing the health, these are not replacement for a Doctor. Please refrain from self diagnosis and medication.

Common symptoms of TB –

1. Prolonged cough (sometimes with blood)
2. Chest pain
3. Weakness
4. Fatigue
5. Weight loss
6. Fever
7. Night sweats

But often patients with latent TB infection don’t feel sick and are not contagious! That is because, TB has 3 kinds of Infection. When TB germs survive and multiply in the lungs, you have a TB infection.

Primary TB Infection: The First Encounter When you’re first exposed to TB bacteria, your body’s immune system goes into action, trying to contain and destroy the invading germs like the way body’s defense systems work. Most people don’t experience any noticeable symptoms during this initial stage. Although, some may develop symptoms such as low fever, fatigue, and a mild cough.
Latent TB Infection: Some times, the primary infection is followed by a latent TB infection. During this stage, the immune system has managed to contain the TB germs within the lungs, effectively building a wall around the infected tissue. The germs remain dormant, unable to cause further harm as long as the immune system keeps them under control. Remarkably, there are no outward symptoms during this latent phase.
Active TB Disease: As good as the last stage sounded, this stage happens when the immune system can no longer control the infection, allowing the TB germs to escape their confinement and spread throughout the lungs or other parts of the body. This active stage can develop shortly after the primary infection or, more commonly, months or even years after the initial latent phase.

How is Tuberculosis Treated?

The treatment of tuberculosis (TB) in India follows a comprehensive approach known as the Revised National Tuberculosis Control Program (RNTCP), which is based on the internationally recommended Directly Observed Treatment, Short-course (DOTS) strategy. Patients are required to take their TB medications under direct observation by a designated treatment supporter or healthcare worker.

But treatment of drug sensitive TB may vary. Please contact your doctor if anyof the above mentioned symptoms persist in you for understanding the scope of treatment.

Risk Factors for Tuberculosis

Compromised Immune System: People with weakened immune systems due to conditions like HIV/AIDS, malnutrition, diabetes, or certain medications (e.g., corticosteroids, anti-cancer drugs) are at higher risk of developing active TB disease.
Poor Living Conditions: Individuals living in overcrowded, poorly ventilated, and unhygienic conditions are more likely to contract TB due to increased exposure to infectious droplets.
Healthcare Workers: Healthcare professionals, especially those working in high-risk settings like TB clinics or hospitals, are at increased risk of exposure to TB bacteria.
Substance Abuse: Alcohol abuse and intravenous drug use can impair the immune system and increase the risk of TB infection and progression to active disease.
Previous TB Infection: People who have previously been infected with TB, even if they received treatment, have a higher risk of developing active TB disease later in life due to the potential reactivation of the dormant bacteria.
Age: Both older adults and young children are more susceptible to developing active TB disease due to their relatively weaker immune systems.
Migration and Travel: People who have recently migrated from or traveled to areas with high TB prevalence, such as parts of Africa, Asia, and Eastern Europe, may be at increased risk of exposure and infection.

Can we prevent Tuberculosis?

Maintaining Good Health and Hygiene One of the most effective ways to prevent tuberculosis in our everyday lives is to prioritize our overall health and practice good hygiene habits. A strong immune system is better equipped to fight off infectious diseases like TB. Eating a balanced diet rich in nutrients, getting regular exercise, and ensuring adequate sleep can all contribute to boosting our body’s natural defenses.

Additionally, practicing proper cough and sneeze etiquette is crucial in preventing the spread of respiratory illnesses, including TB. Covering our mouths and noses when coughing or sneezing, using disposable tissues, and promptly washing our hands can help contain the bacteria and prevent it from spreading through airborne droplets.

Ventilation and Air Quality In both our homes and workplaces, ensuring proper ventilation and air quality is an important step in reducing the risk of TB transmission. Opening windows and doors regularly to allow fresh air circulation can help dilute and remove any airborne bacteria. In poorly ventilated spaces, consider using air purifiers with HEPA filters to capture and remove harmful particles from the air.

For those living or working in crowded or enclosed environments, it’s especially important to be mindful of ventilation and air quality.

Lastly, If you find yourself exposed to TB infected person for long, or you have symptoms and risk factors as we talked above, see a doctor!

When should I see my healthcare provider?

Have you recently been around someone with active tuberculosis (TB)? If so, it’s crucial to notify your healthcare provider immediately. They can evaluate your situation and determine if testing is recommended based on your level of exposure and risk factors.

While exposure doesn’t necessarily mean you’ve contracted the disease, it’s better to be proactive. TB is caused by bacteria that typically attack the lungs, and symptoms can be subtle early on. Fever, cough, night sweats, fatigue, and weight loss are some potential red flags.

Left untreated, TB can lead to devastating consequences. The bacteria can spread from the lungs to other organs, and the disease can even become life-threatening over time. However, with proper antibiotic treatment, most cases of TB can be cured.

Don’t take chances when it comes to your health and the well-being of those around you. Contact your doctor right away if you suspect TB exposure. Early diagnosis and treatment are key to halting the progression of this serious respiratory illness. A simple test can provide peace of mind or jump-start the measures needed to regain your health.

A Final Word

As I mentioned multiple times, these are only for awareness if you have any doubt, please see a doctor.

Left untreated, TB can lead to devastating consequences. The bacteria can spread from the lungs to other organs, and the disease can even become life-threatening over time. However, with proper antibiotic treatment, most cases of TB can be cured.

Sources

WHO
https://www.who.int/health-topics/tuberculosis

https://www.who.int/teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2022/tb-prevention#:~:text=The%20main%20health%20care%20interventions,of%20children%20with%20the%20bacille

Indian Government
https://pib.gov.in/PressReleasePage.aspx?PRID=1808582

Cleaveland Clinic
https://my.clevelandclinic.org/health/diseases/11301-tuberculosis#prevention

Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/tuberculosis/

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