Tuberculosis

March 24th was World TB Day, this commemorated the day in 1882 when Dr. Robert Koch announced the cause of tuberculosis (TB).  He was awarded the Nobel Prize for his discovery of mycobacterium tuberculosis, proving TB disease is caused by a microbe and not by heredity as was previously believed.  TB is an ancient disease; evidence of the disease is seen in skeletal remains more than 8,000 years old.

Tuberculosis is spread in the air; it is not easy to catch and usually requires repeat exposures to cause disease in others.  Most cases of active TB infect the lungs, but it can infect other parts of the body like the lymph nodes, spine, or brain.  The good news is that TB is both preventable and curable.
 
When a person breaths the TB bacteria into their body the immune system often stops the infection from spreading.    This person will have a positive TB test result, but will not feel sick.  They do not have any symptoms of disease, are not contagious, and will have a normal chest x-ray.  This is called TB Infection and this person can be treated with antibiotics to help prevent them from progressing to active disease later in life.

TB Disease occurs when the bacteria spreads in the body and causes symptoms of tuberculosis – fever, weight loss, and night sweats.  The primary site of most active TB disease  is the lungs and symptoms include a cough lasting at least three weeks, coughing up blood, and chest pain.  A person with active TB will need a chest x-ray, lab services, and physician visits along with at least 180 days of medications.  They are assigned a TB case manager, who observes them take their medications and guides them through the diagnosis, treatment, and identification of contacts.

A contact investigation is done by the local health department when a person has active TB of the lungs or voice box.  This involves testing family, friends, and work associates to find both active TB disease and new TB infections to prevent disease outbreaks in the community.   

The United States has a strong TB control program.  As a result of case management, contact investigations, and treatment of TB infections; the average rate of active TB in Missouri in 2014 was only 1.3 cases per 100,000 people.  This is very low compared to the 2014 global average rate of 133 cases per 100,000.  In 2014 it is estimated that 1.5 million persons worldwide died of tuberculosis.  This year the World Health Organization announced that Tuberculosis is the leading cause of infectious disease deaths worldwide.  It is a serious disease that requires sustained efforts to control.
What can you do to help control the spread of TB in your community?  If you have TB infection, take the preventive treatment to lower your life time risk of progressing to active TB from 10% to less than 1%.  If you have active TB, take all your medications and comply with your treatment program.   Be truthful about your contacts, this is your chance to protect your friends, family, and co-workers from getting active TB. 

If a friend or family member has TB, please be supportive; they are sick, worried they may have infected others, and are required to avoid contact with people for a minimum of two weeks while they are contagious.  Bring them food, run errands for them, and offer support for a few weeks as you would any sick friend.  Co-operate with the health department if you are asked to be tested for TB as a contact.  This will protect you and your community.  Most people with active TB are back to their normal activities in just a few weeks.  Remember, let’s Stop TB, it is both preventable and curable.

For additional information please contact your local Health Department.


Author Rebecca Conway, RN works at the Jackson County Health Department.  She serves as a member of the Lee’s SummitHealth Education Advisory Board. 

This article was originally published in Lee's Summit Tribune and Lee's Summit Journal.

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