The disease is spread through the air. When people with TB cough, sneeze or spit, they propel the TB germs into the air. A person needs to inhale only a few of these germs to be infected.

About one-third of the world’s population has latent TB, which means people are infected by TB bacteria but are not yet ill and have not transmitted the disease.

There is a 10 % chance of latent TB becoming active. This risk is much higher in people who have compromised immune systems i.e., people living with HIV or malnutrition, or people who smoke.

When a person develops active TB disease, symptoms such as coughing, fever, night sweats, weight loss etc. may be mild for many months. This can lead to delays in seeking care, and results in transmission of the bacteria to others. People ill with TB can infect up to 10-15 other people through close contact over some time.

What causes tuberculosis

The Mycobacterium tuberculosis bacterium causes TB. It is spread through the air when a person with TB (whose lungs are affected) coughs, sneezes, spits, laughs or talks.

TB is contagious, but it is not easy to catch. The chances of catching TB from someone you live or work with are much higher than from a stranger. Most people with active TB who have received appropriate treatment for at least two weeks are no longer contagious.

Since antibiotics began to be used to fight TB, some strains have become resistant to drugs. Multidrug-resistant TB (MDR-TB) arises when an antibiotic fails to kill all the bacteria that it targets, with the surviving bacteria developing resistance to that antibiotic and often others at the same time.

MDR-TB is treatable and curable only with the use of very specific anti-TB drugs, which are often limited or not readily available. According to the World Health Organisation in 2012, an astonishing 450,000 people developed MDR-TB.

Who is at risk?

People with compromised immune systems are most at risk of developing active tuberculosis.

HIV suppresses the immune system, making it harder for the body to control TB bacteria. People who are infected with both HIV and TB are around 20-30% more likely to develop active TB than those who are HIV negative.

Tobacco use is another major factor that increases the risk of developing active TB. Over 20% of TB cases worldwide are related to smoking.

Symptoms of tuberculosis

While latent TB does not show any symptoms, active TB symptoms include the following:

  • Coughing, sometimes with mucus or blood
  • Chills
  • Fatigue
  • Fever
  • Loss of weight
  • Loss of appetite
  • Night sweats.

Treatments for tuberculosis

The majority of TB cases can be cured when the right medication is available and is administered correctly.

The precise type and length of antibiotic treatment depends on a person’s age, overall health, potential resistance to drugs, whether the TB is latent or active, and the location of infection (i.e. the lungs, brain, kidneys).

People with latent TB may need just one kind of TB antibiotics, whereas people with active TB (particularly MDR-TB) will often require a prescription of multiple drugs.

Antibiotics are taken for relatively longer periods. The standard length of time for a course of TB antibiotics is about 6 months.

All TB medication is toxic to the liver, and although side effects are uncommon, when they do occur, they can be quite serious. Potential side effects have to be reported to a health care provider.

Prevention of tuberculosis

If you have active TB, a face mask can help lower the risk of the disease spreading to other people.

Avoiding other people by not going to school or work, or sleeping in the same room as someone, will help to minimize the risk of germs from reaching anyone else. Wearing a mask, covering the mouth and ventilating rooms can also limit the spread of bacteria.

In some countries, BCG (Bacille Calmette-Guerin) injections are given to children in order to vaccinate them against tuberculosis.

The most important thing to do is to finish entire courses of medication when they are prescribed. MDR-TB bacteria are far deadlier than regular TB bacteria. Some cases of MDR-TB require extensive courses of chemotherapy, which can be expensive and cause severe adverse drug reactions in patients.

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