Tuberculosis, also known as “The White Plague” is a very infectious disease. About 1/3 of the world’s population is believed to be infected with tuberculosis (around 2 billion people). Although numbers of tuberculosis cases are decreasing, the disease should still be taken very seriously. Mycobacterium is the pathogen that causes tuberculosis. It most commonly affects the lungs but if left untreated it can infiltrate the skin, bones and joints. Bone and joint mycobacterium infections typically only occur in infants and elderly people. This is due to infants immune systems not being fully developed and the elderly’s being weakened.
Undeveloped or weak immune systems can’t contain the spread of the bacteria as well as a healthy one. A healthy immune response to tuberculosis would involve the body creating a wall around the bacteria. Then the body encases the surrounded bacteria in scar tissue to prevent the spread of the disease. These sac-like immune defense structures the body forms are known as tubercles. Since the ideal place for tuberculosis pathogens to thrive are the lungs; tubercles are often found in the lungs. When the disease is in the form of tubercles it can stay dormant in the body from weeks to even years before the host even realizes it.
No parts of the body are affected by the bacteria tubercles in this stage of the disease until they’re ruptured. The most common cause of ruptured tubercles is from being infected with another disease while tuberculosis is already present in a person’s body. Even a healthy immune system can become overwhelmed from fighting two diseases. Eventually the tubercle sacks will weaken and rupture from a strong effect of the other disease. For example, someone with tuberculosis catches the common cold virus. While the virus runs its course they experience multiple heavy coughing fits.
Continuous exertion for long periods of time on the lungs leads to many tubercle bursting. Once this occurs the person is considered to have an active infection. Symptoms of an active infection are excessive coughing and hacking up pus. A person is the most contagious in this stage. Airborne transmission is the route in which mycobacterium takes when infecting other organisms. This type of transmission is much harder to avoid. Wearing a mask everywhere to protect yourself is not socially convenient and you cant be cautious around it like bodily fluids because air isn’t visible.
When tuberculosis enters the lungs it takes within six weeks to incubate. Then the disease can lay dormant from weeks to even years. A person may be unaware that they are infected while the disease is in it its dormant stage, since there are usally no symptoms. That is why many jobs require tuberculosis testing previous to a person entering the workforce. The most common method for testing tuberculosis is a PPD injection. It is a small shot just under the skin, not into the flesh or bloodstream. The results take two days. If the body has a reaction to the PPD the person has been infected with tuberculosis.
Advancements in testing technology far surpassed the PPD. The Xpert MTB/RIF rapid molecular test can diagnose tuberculosis within 100 minutes accurately. This is much more efficient if the patient is in serious condition. Although the Xpert MTB/RIF is much faster, hospitals more commonly use the PPD method because it is less costly. After a person has been positively diagnosed with tuberculosis, chest X-Rays are required to see if tubercles have developed or not. Whether there are tubercles or not effects the dosage of medication that will be prescribed.
If tubercles are present more medication will be prescribed for a longer period of time. Antibiotics are the choice medication for tuberculosis since it is a bacterial infection. People with an advanced stage of tuberculosis that are highly contagious will receive care in an isolation room to prevent further spread of the disease. Multiple doses of antibiotics will be given to a patient in an isolation room until their doctor considers them not to be contagious. Traces of tuberculosis will most likely still be found in the body after discharge from the hospital, so doctors are required to prescribe more antibiotics.
Prescriptions for nine months of antibiotics are necessary to rid the body of all mycobacterium. Any surviving pathogens from the first doses are more resistant to the antibiotics. That is why it is extremely important to finish prescriptions and take the doses directed routinely. If doses are missed it can lead to another major infection of antibiotic resistant mycobacterium. Resistant bacteria are much harder to treat and the possibility of surviving the disease is far less. Tuberculosis isn’t as prevalent in the U. S. as other countries like Morocco, South Africa, India, China and other eastern nations.
Around 24 per 100,000 Americans have been diagnosed with tuberculosis compared to more than 300 per 100,000 in all of the nations mentioned previously. Healthcare isn’t as available in the remote regions that these people live in leaving many tuberculosis cases untreated. Not only is tuberculosis left untreated, diseases such as HIV and AIDS run rampid throughout many African countries. HIV and AIDS directly target the immune system leaving the body unable to defend against tuberculosis. Tuberculosis related deaths occur much more often because of this double effect of illnesses and lack of any treatment.
The W. H. O. has been making attempts to make healthcare more available in 3rd world countries to prevent the spread of tuberculosis for years. By sending medication and hired professionals to these places the W. H. O. ’s program has saved 20 million lives and poor nations like Cambodia have had a 45% decrease in tuberculosis since 2002. The W. H. O. is also developing tuberculosis vaccines but faces financial difficulties. High hopes are with the W. H. O. as they set out to reach their goal of 50% total reduction of tuberculosis worldwide by 2015.