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| Tuberculosis |
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While incidents of tuberculosis
(TB) worldwide are predicted to achieve pandemic levels –
100 million by the year 2020 -- the number of cases in the
United States are still low. However, the disease has had
a resurgence with numbers on the rise since 1985.
Tuberculosis spreads from person to person through tiny droplets
that hang in the air when an infected person coughs, sneezes,
sings, laughs or even talks. Usually, it takes frequent and
lengthy contact with a TB-infected person to contract the
disease – which is why family members or people who
work or live in close quarters may be more easily affected.
TB can attack other parts of the body but usually involves
the lungs. The disorder has two distinct forms. When persons
are only infected with TB (M. tuberculosis, or latent TB),
germs or bacteria are present but the body’s natural
defenses protect against the germs. The person is not sick,
not contagious, and no symptoms are apparent. Persons with
active TB are ill and can spread the disease to others. Sometimes
latent TB can turn into active TB, though in the vast majority
of cases this does not happen.
Somewhere between two to eight weeks of having come in contact
with TB germs and being infected, the person’s immune
system takes action by sequestering the affected lung cells,
keeping them separate from healthy cells. This status may
be maintained for years. In many cases, after a time, the
infection goes away altogether and even the bacteria disappear.
If the immune system is weakened, however, the bacteria may
remain and cause latent TB to convert to active TB.
Cause: Reasons cases of TB are currently on the increase
include:
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The rise of HIV/AIDS (which
causes the immune system to be compromised) |
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Large numbers of people entering the
U.S. from countries where TB is more prevalent |
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Poverty and homelessness |
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Drug addiction and abuse |
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More people living close together in
long-term care facilities |
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Failure of some TB victims to complete
their full regimen of antibiotics |
Symptoms: Persistent coughing, coughing up blood, weight
loss and lack of appetite, feeling unusually tired, night
sweats and fever are among the signs of the disease.
Diagnosis: The first step a physician will take is
to administer a simple skin test in which a tiny amount of
a substance is injected just under the skin on the forearm.
If in a few days a hard, raised bump shows up on the injected
area, it means a TB infection is present. People who have
a positive response will then have a chest X-ray. This may
reveal white spots indicating walled-off bacteria. The doctor
may also examine a sample of the patient’s sputum for
bacteria under a microscope.
Treatment: Medications taken over a lengthy period
of time is the mainstay of TB treatment. If the case is latent
TB, preventive therapy may be daily doses of INH (isoniazid)
for six to nine months.
In cases of active TB, several drugs taken in combination
over a period of six to twelve months are necessary to wipe
out the condition. It is so crucial that these drugs be taken
correctly and for the full amount of time prescribed, a healthcare
professional may be charged with actually observing the patient
take the medications.
When patients fail to adhere to the drug-taking schedule,
they may develop multidrug-resistant TB. Treating this strain
requires taking highly toxic medications over a two-year time
period.
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