|
Tuberculosis
(TB)
What is tuberculosis?
Tuberculosis is a bacterial disease usually affecting the lungs (pulmonary
TB). Other parts of the body can also be affected, for example, Iymph
nodes, kidneys, bones, joints, etc. (extrapulmonary TB).
Who gets tuberculosis?
Tuberculosis can affect anyone of any age. Immunocompromised individuals
such as those with AIDS (or those infected with the human immunodeficiency
virus ‹ HIV) are at increased risk.
How is tuberculosis spread?
Tuberculosis is spread through the air. When a person with tuberculosis,
who is not taking tuberculosis medication, coughs or sneezes, the germs
get into the air. Prolonged exposure to the tuberculosis organisms is
normally necessary for infection to occur.
What is the difference between tuberculosis infection and tuberculosis
disease?
Tuberculosis infection may result after close contact with a person
who has tuberculosis disease. Tuberculosis infection is determined by
a significant reaction to the mantoux skin test with no symptoms of
tuberculosis, and no TB organisms found in the sputum. Tuberculosis
disease is characterized by the appearance of symptoms, a significant
reaction to a mantoux skin test and organisms found in the sputum. In
order to spread the TB germs, a person must have TB disease. Having
TB infection is not enough to spread the germ. Tuberculosis may last
for a lifetime as an infection, never developing into disease.
What are the symptoms of tuberculosis?
The symptoms of TB include a low-grade fever, night sweats, fatigue,
weight loss and a persistent cough. Some people may not have obvious
symptoms.
How soon do symptoms appear?
Most people infected with the germ that causes TB never develop active
TB. If active TB does develop, it can occur two to three months after
infection or years later. The risk of active disease lessens as time
passes.
When and for how long is a person able to spread tuberculosis?
A person with TB disease may remain contagious until he/she has been
on appropriate treatment for several weeks. However, a person with TB
infection, but not disease, cannot spread the infection to others, since
there are no TB germs in the sputum.
What is the treatment for tuberculosis?
Preventive: People infected with TB should be evaluated for a course
of preventive therapy, which usually includes taking an antituberculosis
medication for six to 12 months. The exact preventive therapy plan must
be determined by a physician. Curative: People with active TB disease
must complete a course of curative therapy. Initial treatment includes
at least four anti-TB drugs for a minimum of six months. Medications
may be altered based on laboratory test results. The exact medication
plan must be determined by a physician.
What medical conditions increase the risk of developing active TB disease
once TB infection has occurred?
HIV infection, when it occurs in tandem with TB infection, is the
strongest factor in the development of TB disease. People with medical
risk factors which increase the chance of developing TB disease, once
TB infection has occurred, should be skin tested for TB. Their skin
test results should be clearly noted in their medical record. These
medical risk factors include: diabetes mellitus, prolonged corticosteroid
therapy, immunosuppressive therapy, cancer, silicosis and being 10 percent
or more below ideal body weight.
What can be the effect of not being treated for tuberculosis?
In addition to spreading the disease to others, an untreated person
may become severely ill or die.
What can be done to prevent the spread of tuberculosis?
The most important way to stop the spread of tuberculosis is to cover
the mouth and nose when coughing, and to take all the TB medicine exactly
as prescribed by the physician.
What is multiple drug resistant tuberculosis?
This refers to the ability of some strains of TB to grow and multiply
even in the presence of certain drugs which would normally kill them.
Who gets multiple drug resistant tuberculosis (MDR-TB)?
People who have been exposed to a case of MDR-TB, especially if they
are immunocompromised, are at the risk for developing MDR-TB. Other
people who may develop drug resistant tuberculosis include TB patients
who have failed to take antituberculosis medications as prescribed,
TB patients who have been prescribed an ineffective treatment plan and
people who have been treated previously for TB.
What is the treatment for multiple drug resistant tuberculosis?
For patients with disease due to drug resistant organisms, expert
consultation from a specialist in treating drug resistant TB should
be obtained. Patients with drug resistant disease should be treated
with a minimum of two or three drugs to which their organisms are susceptible.
It is presently unknown whether preventive therapy can effectively prevent
the development of active TB disease in people who are infected with
MDR-TB strains. Immunocompromised people who are infected with MDR-TB
are currently being treated with two to three drugs to which the strain
is likely to be susceptible. Recommendations concerning preventive therapy
for people who have been infected with MDR-TB are being developed by
the U.S. Centers for Disease Control (CDC).
What can be done to prevent the spread of MDR tuberculosis?
The most important ways to stop the spread of MDR-TB include educating
the TB patient to cover the mouth and nose when coughing, providing
adequate treatment for people with MDR-TB and providing directly observed
administration of antituberculosis medications for people who are unwilling
or unable to comply with prescribed drug plans.
Source: NY State Department of Health
|
.gif)
