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Tuberculosis

Tuberculosis is a chronic infection caused by the bacteria Mycobacterium tuberculosis(and occasionally other variants of Mycobacterium). It usually involves the lungs, but other organs of the body can also be involved.  TB most commonly affects the lungs but also can involve almost any organ of the body. Many years ago, this disease used to be called “consumption” because without effective treatment, these patients often would waste away. Today, of course, tuberculosis usually can be treated successfully with antibiotics.

Description of Tuberculosis

Today, tuberculosis (TB) tends to be concentrated among inner city dwellers, ethnic minorities and recent immigrants from areas of the world where the disease is still common. Alcoholics, who are often malnourished, are at high risk of developing the disease, as are people infected with HIV. It can occur anywhere, and no one is exempt from the threat of infection.

TB is caused by a germ that is transmitted from person to person by airborne droplets. Usually this infection is passed on as a result of very close contact, so family members of an infected person are endangered if the person continues to live in the same household and has not undergone proper treatment.  If an individual with active TB coughs or sneezes without covering the mouth and nose, droplets containing the tuberculosis germs are sprayed into the air and may be inhaled by anyone near the person. A tissue should always be used to cover the nose and mouth when coughing, sneezing or spitting, and hands should be washed promptly.

Symptoms of Tuberculosis

The first symptoms of an active case of TB may be so commonplace that they are often dismissed as the effects of a cold or flu. The individual may get tired easily, feel slightly feverish or cough frequently. It usually goes away by itself, but about in about half the cases, it will return.

For people who have the disease, TB can cause lung or pleural (the lining of the lung) disease or it may spread through the body via the blood. Often people do not seek the advice of a doctor until they have pronounced symptoms, such as pleurisy (a sharp pain in the chest when breathing deeply or coughing) or the spitting up of blood. Neither of these symptoms is solely of tuberculosis, but they should not be ignored. Other symptoms include fever, loss of appetite, weight loss and night sweats.

TB infection usually occurs initially in the upper part (lobe) of the lungs. The body’s immune system, however, can stop the bacteria from continuing to reproduce. Thus, the immune system can make the lung infection inactive (dormant). On the other hand, if the body’s immune system cannot contain the TB bacteria, the bacteria will reproduce (become active or reactivate) in the lungs and spread elsewhere in the body.

It may take many months from the time the infection initially gets into the lungs until symptoms develop. The usual symptoms that occur with an active TB infection are a generalized tiredness or weakness, weight loss, fever, and night sweats. If the infection in the lung worsens, then further symptoms can include coughing, chest pain, coughing up of sputum (material from the lungs) and/or blood, and shortness of breath. If the infection spreads beyond the lungs, the symptoms will depend upon the organs involved.

A person can become infected with tuberculosis bacteria when he or she inhales minute particles of infected sputum from the air. The bacteria get into the air when someone who has a tuberculosis lung infection coughs, sneezes, shouts, or spits (which is common in some cultures). People who are nearby can then possibly breathe the bacteria into their lungs. You don’t get TB by just touching the clothes or shaking the hands of someone who is infected. Tuberculosis is spread (transmitted) primarily from person to person by breathing infected air during close contact.

There is a form of tuberculosis, however, that is transmitted by drinking unpasteurized milk. Related bacteria, called Mycobacterium bovis, cause this form of TB. Previously, this bacteria was a major cause of TB in children, but it rarely causes TB now since most milk is pasteurized (a heating process that kills the bacteria).

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