What is tuberculosis?
Tuberculosis is an infectious disease caused by mycobacterium tuberculosis (bacteria of the Mycobacterium tuberculosis complex).
Tuberculosis of the lungs is the most common, but the disease can also affect other organs and body systems (such as the kidneys, spine, or brain) in addition to the hair and nails.
How can you get infected?
Tuberculosis (TB) is transmitted from a person who has an open form of TB (with active bacteremia) to another person by airborne droplets, that is, with drops of saliva or mucus during coughing, talking, and sneezing. The risk of infection depends on the duration and intensity of contact and the amount of bacteria inhaled by a healthy person. The probability of developing the disease after contact with bacteria depends on the state of the immune system. If it is not able to contain the infection, tuberculosis develops.
Latent tube infection and tuberculosis
The TB bacterium can "live" in the body without causing the development of the disease. This is called latent tubinfection (LTBI).
Persons with LTBI:
TB disease
The tuberculosis bacterium becomes active if the immune system cannot stop its spread. When the TB bacterium is active (that is, multiplying in the body), it is called TB disease. In this case, symptoms develop, and the patient can infect others until he receives adequate therapy.
Many people with LTBI will never develop the disease. In some patients, the disease develops quickly: within a few weeks after infection - before the immune system begins to fight the bacteria. Others may become ill years later when the immune system weakens for other reasons.
For people with a weakened immune system, especially for those infected with HIV, the risk of developing TB disease is much higher than for people with a normally functioning immune system.
What are the symptoms of the disease?
Symptoms depend on which organ or system is affected. Most often, tuberculosis bacteria infect the lungs. In this case, the following symptoms may be observed:
– cough lasting 3 weeks or more
– chest pain
– coughing up blood
Other possible symptoms of tuberculosis:
– weakness or fatigue
– weight loss
– lack of appetite
– chills
– fever
– profuse sweating at night
There may also be symptoms from other affected organs and systems: for example, back pain in the case of TB of the spine or blood in the urine in the case of TB of the kidneys.
Individuals with latent tubinfection have no symptoms and cannot infect others.
Most people with LTBI will never develop their own TB disease. However, the chances are high for certain groups, namely:
– HIV-infected;
– babies and small children;
– persons with diseases that weaken the immune system;
– patients with diabetes and chronic kidney diseases;
– elderly people;
– persons who did not receive adequate TB therapy in the past.
If the patient is at risk of developing an active form of the disease, the doctor prescribes chemoprophylaxis.
How serious is the disease? What complications are possible?
Tuberculosis is a curable disease, the success of the treatment depends on the timely initiation of effective medication and the patient's discipline in following all the doctor's recommendations and taking medication regularly. However, if not treated, tuberculosis can lead to serious consequences, including death. For example, the chances of such a development of events are high in the event that a child in the first year of life falls ill with tuberculous meningitis or miliary tuberculosis.
The following complications of TB are possible:
– back pain;
– joint damage (tuberculous arthritis);
– inflammation of the meninges (tuberculous meningitis);
– malfunction of the liver and kidneys;
– heart failure.
Tuberculosis develops in approximately 10% of people infected with tuberculosis bacteria. People with weakened immune systems (due to chronic diseases or taking certain medications) and young children are especially susceptible to tuberculosis, as their immune systems are not yet formed. BCG vaccine is used to protect the child from severe forms of tuberculosis.
How can you protect yourself from tuberculosis?
Unfortunately, there is no universal vaccine that would prevent all forms of tuberculosis. Although scientific developments in this direction are being conducted.
Today, in the arsenal of medicine there is a BCG vaccine against severe, generalized forms of tuberculosis, such as tuberculous meningitis and miliary tuberculosis. They are especially dangerous for children of the first year of life.
Without vaccination with the BCG vaccine, the risk of a fatal case in a child who contracts this type of tuberculosis reaches 92%. That is why this vaccine is administered so early — on the 3-5th day of a baby's life. This is the recommended age for vaccination, but children older than 5 days can and should also be vaccinated. If vaccination was not carried out before 2 months of life, the Mantoux test is used to assess the need for vaccination: BCG vaccination is carried out only if the test result is negative. Revaccination with the BCG vaccine is currently not recommended because its effectiveness has not been proven, so this vaccination is given once in a lifetime. During life, a person vaccinated with BCG may get tuberculosis, but will not have a generalized form of TB with multiple lesions of several organs. It is important to note that the BCG vaccine has no age restrictions: in case of a negative result of the Mantoux test in Kosovo, it is recommended to vaccinate children of any age with BCG. What's more: the Ministry of Health recommends that medical workers actively insist on BCG vaccination of children under 5 years of age during each of their visits to a medical facility. In some cases, BCG vaccination may also be indicated for adults: for example, for entry into a country that requires this vaccination; medical workers; persons living in a cell with patients with TB with extended drug resistance, who, due to the peculiarities of the course of TB disease in them, can constantly secrete TB mycobacterium in sputum.
BCG does not guarantee that the child will not get tuberculosis, but it provides full protection against the deadly generalized forms of tuberculosis - tuberculous meningitis and miliary tuberculosis.
What reactions to BCG vaccine administration are possible?
A peculiarity of the BCG vaccine is that most of the vaccinated have a local reaction at the injection site. After 1-6 months, a red papule (spot protruding above the surface of the skin) forms at the injection site, which heals after a few weeks. After 6-12 weeks, a small oozing ulcer may form at the site of the papule: in this case, apply a dry bandage and do not use a patch. The ulcer healing process can take about three months, after which a small scar ("scar") will form. This process is normal and expected (although the absence of a "scar" is also a variant of the norm) and does not require treatment.
General reactions (such as fever and general malaise) to the administration of the BCG vaccine usually do not occur.