Tuberculosis

Tuberculosis | Dr. Ali Ghahary

While it’s not easy to become infected with it, tuberculosis – also commonly known as TB – is still considered to be one of the deadliest diseases in the world, affecting as many as 1.8 billion people according to the World Health Organization. Last year alone, as many as 10 million people worldwide fell ill with TB, while it caused an estimated 1.6 million deaths. That being said, being diagnosed with tuberculosis doesn’t necessarily mean that you will get sick, as there are two different classifications of the disease: Latent TB or Active TB. With latent TB, while you have the germs within your body, they don’t spread – meaning that you don’t have symptoms and you’re not considered contagious. However, that’s not to say that the disease may not one day change from being latent to active. When you have active TB, this is when the TB bacteria will multiple and make you sick, and you can also spread the disease to other individuals.

Those most at risk of developing TB include the following:

• Immunocompromised individuals
• Individuals with IB
• Individuals who have had a TB infection in the last 2 years
• Babies and young children
• Seniors
• Illicit drug users

You’re also at an increased risk of developing tuberculosis if you are from a country where it is more common, such as Africa, Asia, Eastern Europe, Russia, Latin America, and the Caribbean, as well as if you work in a high-risk environment, such as a nursing home or other long-term care facility, correctional facility, or homeless shelter.

While TB can affect any part of the body, it most commonly affects the lungs. Symptoms that are associated with a TB infection include a persisting cough (usually lasting for 3 or more weeks) in addition to coughing up blood, chest pain, fever and chills, night sweats, fatigue, loss of appetite, and weight loss. However, many of these symptoms are often associated with other types of illness, such as the common cold, influenza, and pneumonia – therefore the only way to get a some answers as to whether or not you have tuberculosis is to get tested for it – either by a skin test or a blood test. With the skin test, a small amount of fluid known as tuberculin will be injected into the skin on your arm. Once this is done, you will return anywhere from 48 to 72 hours later to have your arm examined by a healthcare worker for any thickening of the skin. If the healthcare worker determines that the test is positive, then that usually means that you have been infected with TB. What it does not tell you, however, is whether you have developed an active form of TB. Similarly, a blood test will also not tell you if you have clinically active TB. Instead, it will simply measure how your immune system responds to the germs that cause TB. If it is suspected that you have TB then your doctor will likely order other tests, such as a chest X-ray, as well as test your sputum (mucus) to make the final diagnosis.

Even if you’re infected with TB but don’t have an active form of the disease, you should still take preventative measures against it – also known as preventive therapy. Preventive therapy usually consists of taking a daily dose of a medication known as isoniazid (INH) for anywhere from 6 to 9 months, which will kill off any germs that have the potential to do damage in the future. On the other hand, if you have an active form of TB, then your treatment will typically be longer – ranging anywhere from 6 to 12 months – and also be much more complex, as you will be treated with a combination of medications (including isoniazid, as well as other medications such as rifampin, pyrazinamide, and ethambutol.) In addition, you may also require hospitalization for a short time. You should notice a decrease of your symptoms within 2 to 3 weeks after beginning drug therapy. As many medications do, those used to treat TB can also come with side effects – the most common being upset stomach, nausea, vomiting, loss of appetite, itchy skin, rashes, bruising, numbness or tingling of the hands and feet, vision changes, yellowing of the skin or eyes, darker urine, weakness, fatigue, and even fever. Despite these symptoms being common, you should still report them to your physician if you happen to develop them. However, that being said, it is absolutely crucial that you follow whatever instructions your physician has given you, and even more important that you not only take your medications regularly but also finish the full course of treatment in order for it to be successful.