TB is Bacterial Infection

Tuberculosis(TB),Types,Signs and Symptoms

Tuberculosis (TB) is a bacterial infection

Tuberculosis (TB) is a bacterial infection spread through inhaling tiny droplets from the coughs or sneezes of an infected person.

TB is spread from person to person through the air. When people with lung TB cough, sneeze or spit, they propel the TB germs into the air. A person needs to inhale only a few of these germs to become infected.

Tuberculosis (TB) is a contagious infection that usually attacks your lungs. It can also spread to other parts of your body, like your brain, bones, spine and nervous system. A type of bacteria called Mycobacterium tuberculosis causes it.

TUBERCULOSIS TYPES

A TB infection doesn’t always mean you’ll get sick. There are two forms of the disease:

  • Latent TB: You have the germs in your body, but your immune system keeps them from spreading. You don’t have any symptoms, and you’re not contagious. But the infection is still alive and can one day become active. If you’re at high risk for re-activation — for instance, if you have HIV, you had an infection in the past 2 years, your chest X-ray is unusual, or your immune system is weakened — your doctor will give you medications to prevent active TB.
  • Active TB: The germs multiply and make you sick. You can spread the disease to others. Ninety percent of active cases in adults come from a latent TB infection.
  • A latent or active TB infection can also be drug-resistant, meaning certain medications don’t work against the bacteria.

Global impact of TB

  • TB occurs in every part of the world. In 2018, the largest number of new TB cases occurred in the South-East Asian region, with 44% of new cases, followed by the African region, with 24% of new cases and the Western Pacific with 18%.
  • In 2018, 87% of new TB cases occurred in the 30 high TB burden countries. Eight countries accounted for two thirds of the new TB cases: India, China, Indonesia, Philippines, Pakistan, Nigeria, Bangladesh and South Africa.

Tuberculosis Signs and Symptoms

Latent TB doesn’t have symptoms. A skin or blood test can tell if you have it.

Signs of active TB disease include:

  • a persistent cough that lasts more than 3 weeks and usually brings up phlegm, which may be bloody
  • Chest pain
  • Coughing up blood
  • high temperature
  • tiredness and fatigue
  • Night sweats
  • Chills
  • Fever
  • Loss of appetite
  • Weight loss
  • swellings in the neck

If you have any of these symptoms, see your doctor to get tested. Get medical help right away if you have chest pain.

Tuberculosis Risk Factors

You could be more likely to get TB if:

  • A friend, co-worker, or family member has active TB.
  • You live in or have traveled to an area where TB is common, like Russia, Africa, Eastern Europe, Asia, Latin America, and the Caribbean.
  • You’re part of a group in which TB is more likely to spread, or you work or live with someone who is. This includes homeless people, people who have HIV, people in jail or prison, and people who inject drugs into their veins.
  • You work or live in a hospital or nursing home.
  • You’re a health care worker for patients at high risk of TB.
  • You’re a smoker.

A healthy immune system fights the TB bacteria. But you might not be able to fend off active TB disease if you have:

  • HIV or AIDS
  • Diabetes
  • Severe kidney disease
  • Head and neck cancers
  • Cancer treatments such as chemotherapy
  • Low body weight and poor nutrition
  • Medications for organ transplants
  • Certain drugs to treat rheumatoid arthritis, Crohn’s disease, and psoriasis

Babies and young children also have higher chances of getting it because their immune systems aren’t fully formed.

Tuberculosis Tests and Diagnosis

There are two common tests for tuberculosis:

Skin test. This is also known as the Mantoux tuberculin skin test. A technician injects a small amount of fluid into the skin of your lower arm. After 2 or 3 days, they’ll check for swelling in your arm. If your results are positive, you probably have TB bacteria. But you could also get a false positive. If you’ve gotten a tuberculosis vaccine called bacillus Calmette-Guerin (BCG), the test could say that you have TB when you really don’t. The results can also be false negative, saying that you don’t have TB when you really do, if you have a very new infection. You might get this test more than once.

  • Blood test. These tests, also called interferon-gamma release assays (IGRAs), measure the response when TB proteins are mixed with a small amount of your blood.

Those tests don’t tell you if your infection is latent or active. If you get a positive skin or blood test, your doctor will learn which type you have with:

  • A chest X-ray or CT scan to look for changes in your lungs
  • Acid-fast bacillus (AFB) tests for TB bacteria in your sputum, the mucus that comes up when you cough.

Tuberculosis Treatment

Your treatment will depend on your infection.

  • If you have latent TB, your doctor will give you medication to kill the bacteria so the infection doesn’t become active. You might get isoniazid, rifapentine, or rifampin, either alone or combined. You’ll have to take the drugs for up to 9 months. If you see any signs of active TB, call your doctor right away.
  • A combination of medicines also treats active TB. The most common are ethambutol, isoniazid, pyrazinamide, and rifampin. You’ll take them for 6 to 12 months.
  • If you have drug-resistant TB, your doctor might give you one or more different medicines. You may have to take them for much longer, up to 30 months, and they can cause more side effects.

Whatever kind of infection you have, it’s important to finish taking all of your medications, even when you feel better. If you quit too soon, the bacteria can become resistant to the drugs.

You will not usually need to be isolated during this time, but it’s important to take some basic precautions to stop the infection spreading to your family and friends.

You should:

  • stay away from work, school or college until your TB treatment team advises you it’s safe to return
  • always cover your mouth when coughing, sneezing or laughing
  • carefully dispose of any used tissues in a sealed plastic bag
  • open windows when possible to ensure a good supply of fresh air in the areas where you spend time
  • avoid sleeping in the same room as other people

If you’re in close contact with someone who has TB, you may have tests to see whether you’re also infected. These can include a chest X-ray, blood tests, and a skin test called the Mantoux test.

Tuberculosis Medication Side Effects

Like any medication, TB drugs can have side effects.

Common isoniazid side effects include:

  • Numbness and tingling in your hands and feet
  • Upset stomach, nausea, and vomiting
  • Loss of appetite
  • Weakness

Ethambutol side effects may include:

  • Chills
  • Painful or swollen joints
  • Belly pain, nausea, and vomiting
  • Loss of appetite
  • Headache
  • Confusion

Some pyrazinamide side effects include:

  • Lack of energy
  • Nausea and vomiting
  • Loss of appetite
  • Muscle or joint pain

Common rifampin side effects include:

  • Skin rash
  • Upset stomach, nausea, and vomiting
  • Diarrhea
  • Loss of appetite
  • Inflamed pancreas

Tuberculosis Complications

Tuberculosis infection can cause complications such as:

  • Joint damage
  • Lung damage
  • Infection or damage of your bones, spinal cord, brain, or lymph nodes
  • Liver or kidney problems
  • Inflammation of the tissues around your heart

Vaccination for TB

The BCG vaccine offers protection against TB, and is recommended on the NHS for babies, children and adults under the age of 35 who are considered to be at risk of catching TB.

The BCG vaccine is not routinely given to anyone over the age of 35 as there’s no evidence that it works for people in this age group.

Other vaccines are being developed and tested.