HomeHealthIs Tuberculosis A Dangerous Disease?
This Article is From Mar 23, 2017
HealthWritten by Parul ChopraUpdated: March 23, 2017 6:21 pm IST
Tuberculosis is one of the top 10 causes of death worldwide.
World TB Day is designed to build public awareness that tuberculosis today remains an epidemic in much of the world, causing the deaths of nearly one-and-a-half million people each year, mostly in developing countries. It commemorates the day in 1882 when Dr Robert Koch astounded the scientific community by announcing that he had discovered the cause of tuberculosis, the TB bacillus. At the time of Koch's announcement in Berlin, TB was raging through Europe and the Americas, causing the death of one out of every seven people. Koch's discovery opened the way towards diagnosing and curing TB. The theme of World TB Day 2017 is "Unite to End TB."Key facts
- Tuberculosis (TB) is one of the top 10 causes of death worldwide.
- In 2015, 10.4 million people fell ill with TB and 1.8 million died from the disease (including 0.4 million among people with HIV). Over 95% of TB deaths occur in low- and middle-income countries.
- Six countries account for 60% of the total, with India leading the count, followed by Indonesia, China, Nigeria, Pakistan and South Africa.
- In 2015, an estimated 1 million children became ill with TB and 170 000 children died of TB (excluding children with HIV).
- TB is a leading killer of HIV-positive people: in 2015, 35% of HIV deaths were due to TB.
- Globally in 2015, an estimated 480 000 people developed multidrug-resistant TB (MDR-TB).
- TB incidence has fallen by an average of 1.5% per year since 2000. This needs to accelerate to a 4–5% annual decline to reach the 2020 milestones of the "End TB Strategy".
- An estimated 49 million lives were saved through TB diagnosis and treatment between 2000 and 2015.
- Ending the TB epidemic by 2030 is among the health targets of the newly adopted Sustainable Development Goals.
Who is at risk of getting TB?
- Tuberculosis mostly affects adults in their most productive years. However, all age groups are at risk. Over 95% of cases and deaths are in developing countries.
- People who are infected with HIV are 20 to 30 times more likely to develop active TB (see TB and HIV section below). The risk of active TB is also greater in persons suffering from other conditions that impair the immune system.
- Tobacco use greatly increases the risk of TB disease and death. More than 20% of TB cases worldwide are attributable to smoking.
Impact of TBTB occurs in every part of the world. In 2015, the largest number of new TB cases occurred in Asia, with 61% of new cases, followed by Africa, with 26% of new cases.In 2015, 87% of new TB cases occurred in the 30 high TB burden countries. Six countries accounted for 60% of the new TB cases: India, Indonesia, China, Nigeria, Pakistan, and South Africa. Global progress depends on advances in TB prevention and care in these countries.TreatmentTB is a treatable and curable disease. Active, drug-susceptible TB disease is treated with a standard 6 month course of 4 antimicrobial drugs that are provided with information, supervision and support to the patient by a health worker or trained volunteer. Without such support, treatment adherence can be difficult and the disease can spread. The vast majority of TB cases can be cured when medicines are provided and taken properly. Between 2000 and 2015, an estimated 49 million lives were saved through TB diagnosis and treatment.(Source: World Health Organization)
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Tuberculosis is a bacterial infection that is also known as TB. It can be fatal if not treated. TB most often affects your lungs, but can also affect other organs like your brain.
Tuberculosis is an infectious disease that can cause infection in your lungs or other tissues. It commonly affects your lungs, but it can also affect other organs like your spine, brain or kidneys. The word “tuberculosis” comes from a Latin word for "nodule" or something that sticks out.
Tuberculosis is also known as TB. Not everyone who becomes infected with TB gets sick, but if you do get sick you need to be treated.
If you’re infected with the bacterium, but don’t have symptoms, you have inactive tuberculosis or latent tuberculosis infection (also called latent TB). It may seem like TB has gone away, but it’s dormant (sleeping) inside your body.
If you’re infected, develop symptoms and are contagious, you have active tuberculosis or tuberculosis disease (TB disease).
The three stages of TB are:
- Primary infection.
- Latent TB infection.
- Active TB disease.
How common is tuberculosis?
About 10 million people became ill with TB throughout the world, and about 1.5 million people died from the disease in 2020. TB was once the leading cause of death in the U.S. but the number of cases fell rapidly in the 1940s and 1950s after researchers found treatments.
Statistics show that there were 7,860 tuberculosis cases reported in the U.S. in 2021. The national incidence rate is 2.4 cases per 100,000 people.
Are there different kinds of tuberculosis?
In addition to active or inactive, you might hear about different kinds of TB, including the most common, pulmonary (lung) tuberculosis. But the bacterium can also affect other parts of your body besides the lungs, causing extrapulmonary tuberculosis (or TB outside of the lung). You might also hear about systemic miliary tuberculosis, which can spread throughout your body and cause:
- Meningitis, an inflammation of your brain.
- Sterile pyuria, or high levels of white blood cells in your urine.
- Pott’s disease, also called spinal tuberculosis or tuberculosis spondylitis.
- Addison’s disease, an adrenal gland condition.
- Hepatitis, a liver infection.
- Lymphadenitis in your neck, also called scrofula or TB lymphadenitis.
TB is caused by the bacterium Mycobacterium tuberculosis. The germs are spread through the air and usually infect the lungs, but can also infect other parts of the body. Although TB is infectious, it doesn’t spread easily. You usually have to spend a lot of time in contact with someone who is contagious in order to catch it.
How is tuberculosis spread?
TB can be spread when a person with active TB disease releases germs into the air through coughing, sneezing, talking, singing or even laughing. Only people with active pulmonary infection are contagious. Most people who breathe in TB bacteria are able to fight the bacteria and stop it from growing. The bacterium becomes inactive in these individuals, causing a latent TB infection.
As many as 13 million people in the U.S. have latent TB. Although the bacteria are inactive, they still remain alive in the body and can become active later. Some people can have a latent TB infection for a lifetime, without it ever becoming active and developing into TB disease.
However, TB can become active if your immune system becomes weakened and cannot stop the bacteria from growing. This is when the latent TB infection becomes active TB. Many researchers are working on treatments to stop this from happening.
What are the signs and symptoms of tuberculosis?
People with inactive TB do not exhibit symptoms. However, they may have a positive skin reaction test or blood test.
Those with active TB can show any of the following symptoms:
There are two kinds of screening tests for TB: the Mantoux tuberculin skin test (TST) and the blood test, called the interferon gamma release assay (IGRA).
For the TST, a healthcare provider will inject a small amount of a substance called purified protein derivative (PPD) under the skin of your forearm. After two to three days, you must go back to the healthcare provider, who will look at the injection site.
For the IGRA, a healthcare provider will draw blood and send the sample to the lab.
Further tests to determine if an infection is active or if your lungs are infected include:
How do I know if I should get tested for tuberculosis?
You may want to get tested for TB if:
- You are a resident or employee in group settings where the risk is high, such as jails, hospices, skilled nursing facilities, shelters and other healthcare facilities.
- You work in a mycobacteriology laboratory.
- You’ve been in contact with someone who’s known or suspected to have TB disease.
- Your body's resistance to illness is low because of a weak immune system.
- You think you might already have TB disease and have symptoms.
- You’re from a region or have lived in a region where TB disease is prevalent, such as Latin America, the Caribbean, Africa, Asia, Eastern Europe and Russia.
- You’ve injected recreational drugs.
- Your healthcare provider recommends testing.
Others who are at risk for TB include:
- People with immature or impaired immune systems, such as babies and children.
- People with kidney disease, diabetes, or other chronic (long-term) illness.
- People who have received organ transplants.
- People being treated with chemotherapy for cancer or other types of treatments for immune system disorders.
The incidence rates for minority groups in the U.S. are higher than the incidence rates for whites.
TB infection and disease is treated with these drugs:
- Isoniazid (Hyzyd®).
- Rifampin (Rifadin®).
- Ethambutol (Myambutol®).
- Pyrazinamide (Zinamide®).
- Rifapentine (Priftin®).
You must take all of the medication your provider prescribes, or not all of the bacteria will be killed. You will have to take these medications for as long as you're told — sometimes up to nine months.
Some forms of TB have become resistant to medications. It’s very important and likely that your provider will use more than one drug to treat TB. It’s very important to finish your entire prescription.
Some people have side effects from the drugs used to treat TB that may include:
- Skin rashes and other reactions.
- Nausea and stomach upset.
- Itchy skin.
- Yellow skin or eyes (jaundice).
- Dark urine.
Talk to your provider about any side effects because some might mean that you're experiencing liver damage.
How soon after starting treatment for active TB will I feel better?
It will probably take weeks before you start having more energy and fewer days with symptoms. However, it will take longer than that to complete your treatment. You’ll need to take your medications for at least six to nine months.
Can tuberculosis be cured?
Yes, TB is curable.
You usually have to be in contact with someone with active TB for a long time before becoming infected. It helps to follow infection prevention guidelines like:
- Washing your hands thoroughly and often.
- Coughing into your elbow or covering your mouth when you cough.
- Avoiding close contact with other people.
- Making sure you take all of your medication correctly.
- Not returning to work or school until you’ve been cleared by your healthcare provider.
In the hospital, the most important measures to stop the spread of TB are having proper ventilation and using the correct types of personal protective equipment.
Is there a vaccine to prevent tuberculosis?
Some countries (but not the U.S.) use a TB vaccine called Bacillus Calmette-Guerin (BCG). The vaccine is mostly given to children in countries with high rates of TB to prevent meningitis and a serious form of TB called miliary tuberculosis. The vaccine may make skin tests for TB less accurate.
If you have tuberculosis and you’re treated, your outlook is good if you’ve followed directions and taken your medications for as long as you should and in the way you were told.
If you’ve been exposed to TB, you should talk to your healthcare provider right away. They can help you make a decision about getting tested. That decision is more important if you’ve developed any symptoms of illness that could mean you’re contagious. Remember, even though tuberculosis can be treated, it can also be fatal if it’s not treated.
A note from Cleveland Clinic
Tuberculosis is an infection that is spread through the air. Even though it can be treated, it’s still responsible for many deaths around the world. Make sure you contact your healthcare provider if you think you’ve been exposed or have symptoms of TB. Also, make sure to follow instructions if you’re treated for TB. Ask your healthcare provider if you have any questions.
Last reviewed by a Cleveland Clinic medical professional on 05/24/2022.
References
- American Lung Association. Multiple pages were reviewed for this article. Learn About Tuberculosis. (//www.lung.org/lung-health-and-diseases/lung-disease-lookup/tuberculosis/learn-about-tuberculosis.html) Accessed 5/21/2022.
- Centers for Disease Control and Prevention. Multiple pages were reviewed for this article. Tuberculosis (TB). (//www.cdc.gov/tb/) Accessed 5/21/2022.
- Government of Western Australia. Medications to treat tuberculosis. (//www.healthywa.wa.gov.au/Articles/J_M/Medications-to-treat-tuberculosis) Accessed 5/21/2022.
- Merck Manuals Consumer Version. Multiple pages were reviewed for this article. Quick Facts: Tuberculosis and Leprosy: Tuberculosis. (//www.merckmanuals.com/home/quick-facts-infections/tuberculosis-and-leprosy/tuberculosis-tb) Accessed 5/21/2022.
- The Truth About TB. Multiple pages were reviewed for this article. TB Treatment. (//www.thetruthabouttb.org/treatment/) Accessed 5/21/2022.
- World Health Organization. Multiple pages were reviewed for this article. Tuberculosis. (//www.who.int/health-topics/tuberculosis#tab=tab_1) Accessed 5/21/2022.
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