Tuberculosis: Intervention

Mycobacterium tuberculosis causes TB

Basics

Tuberculosis (TB) is a disease that is caused by a type of bacteria that is airborne. A person can obtain the TB bacteria by inhaling the air that a infected TB victim has expelled: coughing, sneezing, speaking, and even singing. The TB bacteria usually attacks the lungs but may also infect the kidneys, spine, and brain; if not treated properly, the disease can be fatal.

Symptoms may include: coughing, fatigue, shortness of breath, weight loss, night sweats, slight fever, pain in the chest, or just overall feeling horribly.

Cycle of Infection

Primary Infection

The Primary infection occurs when a person, mainly children, are given a BCG Vaccine or become exposed to the bacteria in some way. The disease will progress if the immune system cannot fight off the bacteria. Most, however, are able to fight it off.

Latent TB

Having latent TB simply means that the TB bacteria is not active and you are not experiencing any symptoms of TB. This can be good as this means you can treat for it more properly and help keep it from spreading. Interventions: Common medicines for treating include:

  • isoniazid (INH)
  • rifampin (RIF)
  • rifapentine (RPT)

Reactivation

Also known as secondary TB, this is when the victim has a relapse or re exposure to the bacterial and more symptoms may occur. This usually happens when the initial prevention was not executed properly. Other risk factors include:

  • HIV
  • Diabetes
  • Genetics
  • Immunosupression
  • Tobacco smoke
  • Alcohol consumption
  • indoor air pollution

Cavitation

Occurs during secondary infection in adults where semi-liquid necrotic material enters the bronchial tree of the lungs and then is coughed up. Interventions: At this stage antibiotics are given and respiratory isolation may be prescribed depending on severity.

Transimsstion

This is when the bacteria is passed through the air and enters the respiratory system of another person. See Prevention for some interventions taken to avoid this.

Prevention

Preventing TB is easy for some but not all. One of the best things you can do is avoid other people so that you do not give the TB bacteria to other people or by staying away from areas with many cases of the TB. This is not often possible for some people who live in areas of large TB cases or who often travel. Those who are at high risk for developing TB include those: with a HIV infection, who been infected with TB bacteria within 2 years, who are babies or young children, who inject illegal drugs, are sick with other diseases that weaken the immune system, and who were not treated correctly for TB in the past.

If you are looking for a vaccine, then the Bacillus Calmette-Guerin (BCG) Vaccine one to consider. This vaccine is more widely used for children as a preventive but only if they are continually exposed to TB within their own home. They should only give them to adults and/or health care workers depending on the situation they are in.

Testing is a good way to check for TB. There is two kinds of tests: the tuberculin skin test and TB blood test.

Tuberculin skin test involve inserting fluid in the lower arm and waiting for a reaction which takes around 48 to 72 hours. If the test is negative, then the chances of you having TB is slim. If the result is positive, then additional tests are used to determine whether or not the TB is latent or active. One thing to consider is that the BCG Vaccine can influence this testing system by making it positive.

The TB blood test, or the interferon-gamma release assays (IGRA), involves taking blood from the person and checking how strong the immune system reacts to the bacteria that causes TB. If negative, the chances of having latent or active TB is slim, but if positive then you should consult your doctor for treatment options. This is the preferred method of determine TB when the BCG Vaccine has been given to that person or they cannot make another appointment within 2-3 days of the tuberculin test.  

You can also prevent TB within your own household. If someone in your own home has TB, it is bet to keep a distance from that person by isolating a room for them. It is also best to ventilate the house since TB is a airborne disease. The infected person should also take care of how much coughing, sneezing, talking, etc. they do and how to be etiquette and avoid spreading germs.

Overview

There is many community and national programs out there in affect right now in many parts of the world. Each of them are dedicated to helping those with TB and by stopping the spread of the TB bacteria.

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