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Common Diseases

Tuberculosis (TB)

Tuberculosis

Tuberculosis (TB) is a widespread infection that kills nearly 2 million people worldwide annually. So common is the disease that approximately one-third of the human population is infected with it. Research shows that tuberculosis dates back over 5,000 years. While many advances in treatment have been made, the disease remains a global pandemic.

Tuberculosis can be deadly without the proper treatment, but it is controllable if the appropriate care is administered.

Signs and Symptoms

The immune system is often able to fight off TB infection even if a person's body is harboring TB bacteria. Therefore, there is a difference between:

  • TB infection - aka latent TB - A condition that is neither symptomatic nor contagious.
  • Active TB - While symptoms may not develop for many years, active TB is dangerous and spreadable.

Once you have been infected with TB, your immune system will begin to attack the bacteria. Sometimes it is able to successfully eliminate the bacteria and clear up the infection, but in other cases the bacteria may either remain in your body in an inactive state with no symptoms, or you can develop active TB.

Symptoms of active pulmonary TB include:

  • A cough lasting three or more weeks that may produce discolored or bloody sputum
  • Unintended weight loss
  • Fatigue
  • Slight fever
  • Night sweats
  • Chills
  • Loss of appetite
  • Pain with breathing or coughing (pleurisy)

In addition to the lungs, tuberculosis can affect other parts of your body including your joints, bones, urinary tract, central nervous system, muscles, bone marrow and lymphatic system. These other forms of TB produce varied symptoms depending on the organs involved.

Causes

An infection that primarily affects the lungs, tuberculosis spreads through airborne droplets when a person with the infection coughs, talks or sneezes. In most cases one only becomes infected with the disease after prolonged exposure to an infected person. Even after continued exposure, there is no guarantee of contracting the disease. However, symptoms often do not show up until many years later.

The rise of TB

Advances in antibiotic therapy and health programs have resulted in a steady decline in cases of tuberculosis in the United States since the 1940s. However, the disease is still a serious problem in America, and far worse in other countries such as those in sub-Saharan Africa and Southeast Asia. The main reason for TB being so widespread is the increase of those infected with the HIV virus, since the two diseases cause one another to progress. For that reason and because of their compromised immune systems, TB is one of the leading causes of death among people living with AIDS.

In addition, worldwide spread of tuberculosis can be contributed to these factors:

  • Crowded living conditions. Those living in places like prisons, juvenile detention centers and homeless shelters are at a higher risk for contracting TB. Nursing homes can also be breeding grounds due to the weakened immune systems of the older adults who reside there.
  • Increased numbers of foreign-born nationals. While it's true that incidences of TB are on the decline for those born in the United States, the disease is on the rise for those born in other parts of the world, especially Africa, Asia and Latin America. The majority of reported cases of TB in the US are people born in other countries.
  • Poverty and poor health care. Poor people in America and throughout the world have a higher risk of contracting TB, yet they are the least likely to receive medical care.
  • Increase in drug-resistant strains of TB. For each major TB medication, there's a TB strain that resists its treatment. There are even strains that are resistant to at least two anti-TB drugs, leading to a condition called multidrug-resistant TB (MDR-TB).

Risk Factors

TB does not discriminate against age, race or nationality. However, there are certain factors that can increase your risk of contracting it:

  • Lowered immunity. Healthy immune systems produce macrophages that are often able to defend the body against TB bacteria, but weakened immune systems are not as successful.
  • Prolonged exposure to the disease. In order to contract the disease, you would generally need to spend a great deal of time with someone with untreated, active TB.
  • Nationality. People from regions with high rates of TB - especially Africa, Asia and Latin America, and in the case of MDR-TB, the former Soviet Union - are more likely to develop TB.
  • Age. Older adults are at greater risk of TB due to their weakened immune systems. They're also more likely to live in nursing homes, the risk of occurence is also greater.
  • Substance abuse. Long-term drug or alcohol use weakens your immune system and makes you more vulnerable to TB.
  • Malnutrition. A poor diet or one too low in calories puts you at greater risk of TB.
  • Lack of medical care. If you are on a low or fixed income, live in a remote area, have recently immigrated to the United States, or are homeless, you may lack access to the medical care you need to diagnose and treat TB.
  • Living or working in a residential care facility. People who live or work in prisons, immigration centers or nursing homes are all at risk of TB. That's because the risk of the disease is higher anywhere there is overcrowding and poor ventilation.
  • Living in a refugee camp or shelter. Weakened by poor nutrition and ill health and living in crowded, unsanitary conditions, refugees are at especially high risk of TB infection.
  • Health care work. Regular contact with people who are ill increases your chances of exposure to TB bacteria. Wearing a mask and frequent hand washing greatly reduce your risk.
  • International travel. As people migrate and travel widely, they may expose others or be exposed to TB bacteria.