Tuberculosis (TB) isn’t something we hear about often in the United States as it mostly affects people who live in developing countries. However, new statistics have been released that show for the first time in 23 years, TB is on the rise in the U.S.
What do we know about TB?
Tuberculosis is a contagious and often severe airborne disease caused by infection with Mycobacterium tuberculosis (Mtb) bacteria. TB typically affects the lungs, but it also can affect any other organ of the body. It is usually treated with a regimen of drugs taken for six months to two years depending on whether the infecting organisms are drug resistant.
Tuberculosis is one of the major causes of disability and death worldwide. More than 95 percent of TB deaths occur in low- and middle-income countries, according to the World Health Organization. In 2014, 9.6 million people became ill with TB, and 1.5 million people died from the disease. TB is a leading cause of death for people infected with HIV. In 2015, 1 in 3 HIV deaths was due to TB, and the two are considered a co-epidemic. Globally in 2014, an estimated 480,000 people developed multidrug-resistant TB (MDR-TB).
There are two types of TB:
Latent TB – the bacteria remain in the body in an inactive state. They cause no symptoms and are not contagious, but they can become active.
Active TB – the bacteria do cause symptoms and can be transmitted to others.
About one-third of the world’s population is believed to have latent TB. There is a 10 percent chance of latent TB becoming active, but this risk is much higher in people who have compromised immune systems i.e., people living with HIV or malnutrition, or people who smoke.
TB affects all age groups and all parts of the world. However, the disease mostly affects young adults and people living in developing countries.
The chances of getting infected with TB are highest for people that are in close contact with others who are infected. This includes:
- Family and friends of a person with infectious TB disease
- Persons who have immigrated from areas of the world with high rates of TB
- People in groups with high rates of TB transmission, including the homeless persons, injection drug users, and people living with HIV infection
- People who work or reside in facilities or institutions that house people who are at high risk for TB such as hospitals, homeless shelters, correctional facilities, nursing homes, and residential homes for those with HIV
Can you prevent TB?
There is a vaccine for TB called Bacille Calmette-Gurin (BCG). However, it is not generally recommended in the United States because it has limited effectiveness for preventing TB overall. It is predominantly used to prevent severe forms of TB in children.
Researches are engaged across the globe to find new ways to prevent TB in children and adults. They are also trying to understand how TB can lay dormant for years and become active in life. This knowledge will help find ways to develop new vaccines that are able to prevent TB from infecting people or prevent it from progressing from latent to active TB.
What are the symptoms of TB?
A person with latent TB infection will have no symptoms. A person with active TB disease may have any or all of the following symptoms:
- A persistent cough
- Constant fatigue
- Weight loss
- Loss of appetite
- Coughing up blood
- Night sweats
TB and HIV: A a co-epidemic
Substance abuse plays a significant factor in infection and disease progression for HIV and AIDS. Although HIV/AIDS can affect anyone, the risk of infection is significantly higher in patients suffering from substance abuse, whether the risk is of direct exposure through needles or increased likelihood of high risk behavior due to loss of judgment. Not only does substance abuse increase your risk of infection, but some abused substances can also interfere with effectiveness of treatment of the disease and its progression.
HIV and tuberculosis (TB) are so closely connected that their relationship is often described as a co-epidemic. In the last 15 years the number of new TB cases has more than doubled in countries where the number of HIV infections is also high.
TB and HIV statistics:
- The two diseases are a deadly combination; they are far more destructive together than either disease alone.
- In developing countries many people infected with HIV contract TB as the first sign of AIDS
- At least one-third of the 38.6 million HIV-positive people in the world are also infected with TB and are at greatly increased risk of developing TB disease (the active and contagious form of TB)
- TB is the leading cause of illness and death among people living with HIV in Africa and a major cause of death in HIV-positive people living elsewhere. In some settings, TB kills up to half of all AIDS patients
What is the course of treatment for TB?
Treatment for TB depends on whether a person has clinically active TB disease or only TB infection.
If you have latent TB, you should get preventive therapy. This treatment kills germs that are not doing any damage right now, but could so do in the future. The most common preventive therapy is a daily dose of isoniazid (INH) taken as a single daily pill for 6 to 9 months.
If you have active TB disease you will probably be treated with a combination of several drugs for 6 to 12 months. You may only have to stay a short time in the hospital, if at all, and can then continue taking medication at home. After a few weeks you can probably even return to normal activities and not have to worry about infecting others.
The most common treatment for active TB is INH plus three other drugs—rifampin, pyrazinamide and ethambutol. You will probably begin to feel better only a few weeks after starting to take the drugs.
It is very important that you continue to take the medicine correctly as prescribed by your doctor for the full length of treatment.