Tuberculosis is one of the most common infectious diseases. Worldwide, it is estimated that more than 10 million people contract the disease each year, and more than 1 million people die from it annually. Many know tuberculosis mainly from historical works. Think of sanatoriums in the mountains. In Germany, the disease has become rare thanks to good care and hygiene. But here, too, almost 6,000 people are affected every year.
At a glance
Tuberculosis is caused by bacteria. Mostly affects the lungs. Often the body's own defenses fight off the pathogens. If it is weakened, the disease can break out.
Signs are cough, unwanted weight loss, fatigue, slight fever or night sweats. Examinations are an X-ray image of the lungs. Detection of the pathogens in sputum.
Tuberculosis can usually be treated well with antibiotics. The usual treatment lasts 6 months.
Tuberculosis (short: TB or Tbc) is a contagious disease caused by bacteria.
The bacteria predominantly affect the lungs. An affected person, when speaking, sneezing or coughing, releases germ-containing droplets that others can breathe in with the air. But not everyone who comes into contact with the bacteria becomes ill. The body's own defenses fight off the pathogens. Often renders it harmless. Sometimes the bacteria remain dormant in the body for years. With weakened defenses the bacteria can spread in the body, among other things in lymph nodes, bones, urinary tract or meninges.
Who gets sick?
About one in ten people develop the disease and need treatment. Affected are mainly close contacts of patients with infectious pulmonary tuberculosis and people with weakened defenses, which are mainly:
People with HIV or AIDS
Infants, small children and older people
People who permanently take drugs that suppress the immune system
People who are addicted to drugs or alcohol
Signs and symptoms
Tuberculosis can break out without those affected realizing it. It often starts insidiously, and the symptoms are often not clear:
– coughing or coughing with or without sputum – unwanted weight loss – fatigue – slight fever – night sweats
The complaints last for weeks. If left untreated, it usually worsens. In former times the disease was also called "consumption".
If a cough persists for a long time, doctors recommend an X-ray of the lungs to clarify the cause of the cough. If tuberculosis is suspected, the diagnosis is confirmed by detecting the bacteria, for example in the sputum.
Obligation to report
Physicians are required by law to report tuberculosis requiring treatment to the public health department. In the case of contagious tuberculosis, this causes examinations to be carried out on close contacts of the person with the disease. This is called environmental testing.
Persons who have been infected can receive preventive treatment at an early stage. This is to prevent an outbreak of the disease and its further spread.
Tuberculosis can usually be treated well. Without treatment, about 7 out of 10 people with the disease die; in the case of resistance (see below), however, the prospects for a cure are much poorer.
The usual treatment lasts 6 months. Affected persons are given medication that kills the bacteria, so-called Antibiotics: four agents in the first 2 months, two in the following 4 months. You take these every day at the same time.
Experts recommend that every tuberculosis sufferer be offered counseling and an HIV test. If the test is positive, the HIV disease is also treated.
Treatment problem: Resistance
One problem is that the bacteria are becoming increasingly insensitive – resistant – to the most important drugs. Such resistance arises mainly because the drugs are not used properly.
The so-called multidrug-resistant tuberculosis is more difficult to treat and often longer contagious. Treatment lasts at least 20 months. Should only be done in an experienced center.
What you can do yourself
– You can protect yourself from infection by keeping a certain distance from people who are coughing. Also follow general rules for hygiene, such as washing your hands regularly.
– Vaccination against tuberculosis is no longer recommended in Germany.
If you have tuberculosis:
At the beginning you are still infectious despite taking the medication. They are therefore isolated at home or in a clinic. It is important that you wear a mouth guard to limit the spread of bacteria. You can return to your daily routine only when you are no longer contagious.
Take your medicines as prescribed by your doctor – even if you are already feeling much better. Otherwise a relapse may occur. This means not only a prolonged period of illness, but also more difficult further treatment.
The antibiotics may be better tolerated if you take them after a light meal.
Smoking is especially harmful in pulmonary tuberculosis. If possible, refrain from smoking.
Take care of your control examinations during and after the treatment. Side effects of the drugs or ineffective treatment as well as a relapse can be detected at an early stage. Under certain circumstances a drug is then exchanged.