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 Fever & Infection

March 2010
Prevent Tuberculoseis
Dr Shravan Bohra
 
March 24th is observed as World TB Day – our periodic shot in the arm against one of the world’s deadliest diseases. TB claims two million lives every month around the world, and is a leading killer of the HIV infected. TB claims two lives every three minutes in India, today. But the good news is that these deaths can be prevented.
With proper care and treatment, TB patients can be cured and the battle against TB, won. Tuberculosis is a disease caused by the bacterium Mycobacterium tuberculosis. Though the bacteria usually attack the lungs, they can attack any part of the body such as the kidney, spine and brain. If not treated properly, TB disease can be fatal.

How TB Spreads
Mycobacterium tuberculosis spreads through the air when a person suffering from TB coughs, sneezes, speaks or sings. A single patient can infect 10 or more people in a year! But TB does not spread by shaking the patient’s hand, sharing his food or drink, touching his bed linen or toilet seats or even sharing his toothbrush! Not everyone infected with TB bacteria becomes sick. As a result, two TB-related conditions exist: latent TB infection and active TB disease.

Latent TB
TB bacteria can live in your body without making you sick. This is called Latent TB Infection (LTBI). In most people who breathe in TB bacteria and become infected, their body is able to fight the bacteria to stop them from growing. People with latent TB infection neither feel sick, sport symptoms, nor spread the germs to others. The only sign of TB infection would be a positive reaction to the tuberculin skin test or special TB blood test. These people may develop TB disease in the future, and treatment is prescribed to prevent it. Because there are less bacteria in a person with latent TB infection, treatment is much easier. Usually, only one drug is needed to treat latent TB infection.

TB Disease
TB bacteria become active and multiply in your body if your immune system can’t stop them from growing – and that’s what we call TB disease. People with TB disease may spread the bacteria to people they spend time with, every day. Many who have latent TB infection never develop TB disease. Some develop TB disease soon after becoming infected (within weeks), before their immune system can fight the TB bacteria. Others may fall sick years later, when their immune system becomes weak for some other reason. For those whose immune systems are weak, especially those with HIV infection, the risk of developing TB disease is much higher.

A person with active TB disease has a large amount of TB bacteria in his body. TB disease can be treated by taking several drugs for six to 12 months. It is very important that people who have TB disease 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 germs that are still alive may become resistant to those drugs! TB that is resistant to drugs is harder and more expensive to treat.

5 Symptoms of Active TB
Cough with thick, cloudy, and sometimes bloody mucus from the lungs for more than two weeks
  1. Fever, chills, and night sweats
  2. Fatigue and weakness
  3. Loss of appetite and unexplained weight loss
  4. Shortness of breath and chest pain
Are you at Risk?
Many people who have latent TB infection never develop active TB disease, though some are more likely to develop active TB disease than others. Those at high risk for developing active TB disease include
  • People with HIV infection
  • People who became infected with TB bacteria in the last two years
  • Babies and young children
  • People who take injectible illegal drugs
  • People who are sick with other diseases that weaken the immune system
  • Elderly people
  • People who were not treated correctly for TB in the past
    If you have latent TB infection and you are in one of these high-risk groups, you need to take prescribed medication to keep from developing active TB disease. There are several treatment options. You and your health care provider must decide which treatment is best for you.

    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 had last spent time with a person who has TB. 
Dr. Shravan Bohra - Liver Diseases specialist at Apollo Hospitals, Ahmedabad

    
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