What is Tuberculosis (TB / Tibi)?
Tuberculosis (TB / Tibi) is caused by a bacterium called Mycobacterium tuberculosis. The bacteria usually attack the lungs, but TB bacteria can attack any part of the body such as the kidney, spine, and brain.
Not everyone infected with TB bacteria becomes sick. As a result, two TB-related conditions exist: latent TB infection (LTBI) and TB disease.
If not treated properly, TB disease can be fatal.
NOTE ON SOURCE: This post by Dr Nurul is a combination of Tuberculosis written content taken from Centers for Disease Control & Prevention (CDC) and video conent from her regular Facebook LIVE Videos on her Facebook page.
Why Tuberculosis is NOT something to ignore in Malaysia
How Does Tuberculosis (TB / Tibi) Spread?
TB bacteria are spread through the air from one person to another. The TB bacteria are put into the air when a person with TB disease of the lungs or throat coughs, speaks, or sings. People nearby may breathe in these bacteria and become infected.
TB is NOT spread by
- shaking someone’s hand
- sharing food or drink
- touching bed linens or toilet seats
- sharing toothbrushes
- kissing
When a person breathes in TB bacteria, the bacteria can settle in the lungs and begin to grow. From there, they can move through the blood to other parts of the body, such as the kidney, spine, and brain.
TB disease in the lungs or throat can be infectious. This means that the bacteria can be spread to other people. TB in other parts of the body, such as the kidney or spine, is usually not infectious.
People with TB disease are most likely to spread it to people they spend time with every day. This includes family members, friends, and coworkers or schoolmates.
Latent TB Infection And TB Disease – What Is The Difference?
Not everyone infected with TB bacteria becomes sick. As a result, two TB-related conditions exist: latent TB infection and TB disease.
Latent TB Infection
TB bacteria can live in the body without making you sick. This is called latent TB infection. In most people who breathe in TB bacteria and become infected, the body is able to fight the bacteria to stop them from growing. People with latent TB infection:
- Have no symptoms
- Don’t feel sick
- Can’t spread TB bacteria to others
- Usually have a positive TB skin test reaction or positive TB blood test
- May develop TB disease if they do not receive treatment for latent TB infection
Many people who have latent TB infection never develop TB disease. In these people, the TB bacteria remain inactive for a lifetime without causing disease. But in other people, especially people who have a weak immune system, the bacteria become active, multiply, and cause TB disease.
TB Disease
TB bacteria become active if the immune system can’t stop them from growing. When TB bacteria are active (multiplying in your body), this is called TB disease. People with TB disease are sick. They may also be able to spread the bacteria to people they spend time with every day.
Many people who have latent TB infection never develop TB disease. Some people develop TB disease soon after becoming infected (within weeks) before their immune system can fight the TB bacteria. Other people may get sick years later when their immune system becomes weak for another reason.
For people whose immune systems are weak, especially those with HIV infection, the risk of developing TB disease is much higher than for people with normal immune systems.
The Difference between Latent TB Infection (LTBI) and TB Disease
| A Person with Latent TB Infection | A Person with TB Disease |
|---|---|
| Has no symptoms | Has symptoms that may includea bad cough that lasts 3 weeks or longerpain in the chestcoughing up blood or sputumweakness or fatigueweight lossno appetitechillsfeversweating at night |
| Does not feel sick | Usually feels sick |
| Cannot spread TB bacteria to others | May spread TB bacteria to others |
| Usually has a skin test or blood test result indicating TB infection | Usually has a skin test or blood test result indicating TB infection |
| Has a normal chest x-ray and a negative sputum smear | May have an abnormal chest x-ray, or positive sputum smear or culture |
| Needs treatment for latent TB infection to prevent TB disease | Needs treatment to treat TB disease |
What Are The Symptoms Of Tuberculosis (TB / Tibi)?
Symptoms of TB disease depend on where in the body the TB bacteria are growing. TB bacteria usually grow in the lungs (pulmonary TB). TB disease in the lungs may cause symptoms such as
- a bad cough that lasts 3 weeks or longer
- pain in the chest
- coughing up blood or sputum (phlegm from deep inside the lungs)
Other symptoms of TB disease are
- weakness or fatigue
- weight loss
- no appetite
- chills
- fever
- sweating at night
Symptoms of TB disease in other parts of the body depend on the area affected.
People who have latent TB infection do not feel sick, do not have any symptoms, and cannot spread TB to others.
What Are The Risk Factors For Tuberculosis (TB / Tibi)?
Some people develop TB disease soon after becoming infected (within weeks) before their immune system can fight the TB bacteria. Other people may get sick years later, when their immune system becomes weak for another reason.
Overall, about 5 to 10% of infected persons who do not receive treatment for latent TB infection will develop TB disease at some time in their lives. For persons whose immune systems are weak, especially those with HIV infection, the risk of developing TB disease is much higher than for persons with normal immune systems.
Generally, persons at high risk for developing TB disease fall into two categories:
- Persons who have been recently infected with TB bacteria
- Persons with medical conditions that weaken the immune system
Persons who have been Recently Infected with TB Bacteria
This includes:
- Close contacts of a person with infectious TB disease
- Persons who have immigrated from areas of the world with high rates of TB
- Children less than 5 years of age who have a positive TB test
- Groups with high rates of TB transmission, such as homeless persons, injection drug users, and persons with HIV infection
- Persons who work or reside with people who are at high risk for TB in facilities or institutions such as hospitals, homeless shelters, correctional facilities, nursing homes, and residential homes for those with HIV
Persons with Medical Conditions that Weaken the Immune System
Babies and young children often have weak immune systems. Other people can have weak immune systems, too, especially people with any of these conditions:
- HIV infection (the virus that causes AIDS)
- Substance abuse
- Silicosis
- Diabetes mellitus
- Severe kidney disease
- Low body weight
- Organ transplants
- Head and neck cancer
- Medical treatments such as corticosteroids or organ transplant
- Specialized treatment for rheumatoid arthritis or Crohn’s disease
Exposure To Tuberculosis (TB / Tibi) And What To Do About It
You may have been exposed to TB bacteria if you spent time near someone with TB disease. The TB bacteria are put into the air when a person with active TB disease of the lungs or throat coughs, sneezes, speaks, or sings. You cannot get TB from
- Clothes
- Drinking glass
- Eating utensils
- Handshake
- Toilet
- Other surfaces
If you think you have been exposed to someone with TB disease, you should contact your doctor or local health department about getting a TB skin test or a special TB blood test. Be sure to tell the doctor or nurse when you spent time with the person who has TB disease.
It is important to know that a person who is exposed to TB bacteria is not able to spread the bacteria to other people right away. Only persons with active TB disease can spread TB bacteria to others. Before you would be able to spread TB to others, you would have to breathe in TB bacteria and become infected. Then the active bacteria would have to multiply in your body and cause active TB disease. At this point, you could possibly spread TB bacteria to others. People with TB disease are most likely to spread the bacteria to people they spend time with every day, such as family members, friends, coworkers, or schoolmates.
Some people develop TB disease soon (within weeks) after becoming infected, before their immune system can fight the TB bacteria. Other people may get sick years later, when their immune system becomes weak for another reason. Many people with TB infection never develop TB disease.
How Is Tuberculosis (TB / Tibi) Tested & Diagnosed?
There are two kinds of tests that are used to detect TB bacteria in the body: the TB skin test (TST) and TB blood tests.
A positive TB skin test or TB blood test only tells that a person has been infected with TB bacteria. It does not tell whether the person has latent TB infection (LTBI) or has progressed to TB disease. Other tests, such as a chest x-ray and a sample of sputum, are needed to see whether the person has TB disease.
TB 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.
TB 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.
Remember, these 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.
What Is The Treatment For Tuberculosis (TB / Tibi) In Malaysia?
When TB bacteria become active (multiplying in the body) and the immune system can’t stop the bacteria from growing, this is called TB disease. TB disease will make a person sick. People with TB disease may spread the bacteria to people with whom they spend many hours.
A combination of medicines are needed to treat active TB disease. They are ethambutol, isoniazid, pyrazinamide, and rifampin. With additional add on of vitamin B6 (Pyridoxine). 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.
It is very important that people who have TB disease are treated, finish the medicine, and take the drugs exactly as prescribed. If they stop taking the drugs too soon, they can become sick again; if they do not take the drugs correctly, the TB bacteria that are still alive may become resistant to those drugs. TB that is resistant to drugs is harder and more expensive to treat.
What About Treatment For Latent TB Infection?
People with latent TB infection do not have symptoms, and they cannot spread TB bacteria to others. However, if latent TB bacteria become active in the body and multiply, the person will go from having latent TB infection to being sick with TB disease. For this reason, people with latent TB infection should be treated to prevent them from developing TB disease.
If you suspect you may be suffering from Tuberculosis, you can schedule an appointment with Dr Nurul HERE
