SCRIPT NUMBER 109
TUBERCULOSIS - 2
(ONE SPEAKER)
PROGRAM NAME: HEALTH NUGGETS
PROGRAM TITLE: TUBERCULOSIS - 2
PROGRAM NUMBER: 109
SUBJECT: CAUSES, PATHOLOGY, SYMPTOMS, COMPLICATIONS,
DIAGNOSIS, TREATMENT, PREVENTION OF TUBERCULOSIS
KEY WORDS: BACTERIUM, HUMAN IMMUNO-DEFICIENCY VIRUS, AIDS,
IMMUNE SYSTEM, ANTIBIOTICS, VACCINE
DATE OF SCRIPT: APRIL 26, 2013
AUTHOR: RICHARD YUKL, MD, FACS
Sabina was a young mother living in India. She had given birth to her first-born, a
healthy boy. She named him Aashi because he made her smile. When Aashi
was six months old, Sabina decided to take him to the big city to meet his uncle
and her brother. The trip was difficult, and, once they arrived in the city, Sabina
was faced with a disturbing problem. Her brother had been coughing up blood,
and now the doctor had diagnosed him with active tuberculosis. Was her
precious Aashi safe? Did she need to protect him, and if so, what should she do?
Today, I want to talk about tuberculosis and it’s dangers.
Tuberculosis is a lung infection that is the seventh greatest cause of death on
Earth. It kills nearly two million people every year. The infection is caused by a
bacterium, a germ that is spread to others through the air when an infected
person coughs or sneezes onto others in a crowd, or onto someone who lives or
works near them. Tuberculosis was once a common disease in poor countries
but uncommon in fully developed countries. Starting in 1985, however, the
number of reported cases in fully developed countries began to rise rapidly. In
that year, a new virus called HIV, or Human Immuno-deficiency Virus, became
known. The HIV virus and the disease it causes called AIDS are extremely
important topics that deserve their own discussion. I will talk about them on
another episode of this program. What we need to understand today is that the
HIV virus destroys our ability to fight infections.
When God created us, he gave us a sophisticated defense mechanism to help us
fight infections. It is called our immune system. When a person in good health is
exposed to a bacterium such as the one that causes tuberculosis, their immune
system will most often either kill the germ, or cause it to become dormant, and an
infection does not develop.
Any condition that weakens that immune system, however, will increase one’s
risk of developing an active infection. Conditions such as aging, poor nutrition,
receiving chemotherapy for cancer, or taking medicines to prevent rejection
following organ transplant weaken the immune system. They increase the risk of
developing tuberculosis. Likewise, diseases such as diabetes or developing an
HIV virus infection damage one’s immune system. So, active tuberculosis often
follows exposure to the organism.
Active tuberculosis starts as an infection in your lungs, but it can spread to other
parts of the body through your blood. The infection can spread to your brain
where it causes swelling of the lining tissues that cover your brain and spinal
cord. It can spread to your bones, where it will destroy your joints and cause your
bones to break. Tuberculosis can spread to your heart. There, it interferes with
your heart’s ability to pump blood effectively. If infection spreads to organs such
as your kidneys or liver, those organs can fail.
Within a few weeks of exposure to tuberculosis, an at-risk person can develop
clinical symptoms such as a cough, fever, chills and night sweats. They can lose
their appetite, suffer unexpected weight loss and feel very tired. As symptoms
appear, it is extremely important to see a doctor. Active tuberculosis must be
treated rapidly because, without treatment, it can cause death.
A skin test usually makes the diagnosis. The doctor will inject a small amount of
test fluid into the skin of your arm. If the test becomes positive with swelling
around the injection site, you have been exposed to the tuberculosis bacterium.
A chest x-ray may also show spots on your lungs that are specific for
tuberculosis. Or, a doctor can make the diagnosis by checking the material you
cough up from your lungs for the tuberculosis organism.
Antibiotics are very effective in treating active tuberculosis. Unfortunately, the
bacterium grows very slowly, so you have to take the antibiotics for a long time not for a week as with many infections, but for six to nine months! Your doctor
will give you several antibiotics to take at the same time so that your infection
doesn’t become resistant to a single antibiotic.
So, what should Sabina do to prevent her baby from becoming infected her
brother’s tuberculosis infection? Keep Aashi far enough away from his uncle so
that coughing or sneezing does not spray onto him. Ask her brother to wear a
mask. That may offend him, but it helps to prevent passing the infection on to
others. Finally, a vaccine against tuberculosis is available. It can be given to
children, the aged, those who have a damaged immune system, and the family
and friends of anyone recently diagnosed with the infection.
If you are suffering an active tuberculosis infection, there are several things you
can do to keep from spreading it to your family and friends. Most importantly, get
started on the antibiotics prescribed by a doctor. Be faithful to take all of your
medicines. Finish your entire treatment course even though taking medicines for
six to nine months may become bothersome. Next, avoid close physical contact
with your family and friends. Sleep in a room by yourself, and don’t go to work or
school until your infection is controlled. The bacterium is spread more easily in
small, closed spaces where air doesn’t move, so open the windows or use a fan
to blow air out of your room to the outside. Finally, if you have to be around other
people, wear a mask that covers your nose and mouth when you cough and
sneeze. This is especially important in the first several weeks of treatment,
before antibiotics have had a chance to start controlling the infection.
Health Nuggets is written by Dr. Richard Yukl, a medical doctor working in the
United States. The medical views expressed in this program are his and may
differ for your particular health needs. If you need medical advice, please consult
a medical professional in your area.