Tuberculosis (TB) is a contagious bacterial infection that mainly targets the lungs, but with proper treatment, it can be cured. Despite this, TB remains a major global health issue, causing about 1.5 million deaths annually. The World Health Organization identifies it as the world’s deadliest infectious disease.
In places like the United States and Western Europe, TB rates are low. However, it’s more common in sub-Saharan Africa, Eastern Europe, and Asia.
When TB bacteria enter the lungs, they can either stay dormant or quickly cause illness. A dormant infection is called latent TB, which means the bacteria are inactive and the person has no symptoms or risk of spreading it. Sometimes, the immune system can eliminate the bacteria altogether. But if not, it may remain inactive for years before potentially developing into active TB disease, which occurs in a small proportion of those exposed, especially individuals with weakened immune systems.
Active TB can manifest with symptoms such as fever and weight loss, and sometimes without any signs, which is why testing after potential exposure is crucial. Although mostly affecting the lungs, TB can spread to other organs like the kidneys, liver, and brain.
Some TB strains have become resistant to conventional drugs, termed multidrug-resistant (MDR) TB, making them tougher to treat. This resistance often develops when people don’t finish their treatment, allowing the bacteria to survive and adapt to the drugs. In rare cases, TB can become resistant to nearly all treatments, known as extensively drug-resistant TB.
Understanding TB symptoms is vital, especially with a latent infection. Common symptoms include coughing up blood, although not everyone will experience this. TB spreads through airborne droplets when someone with the infection coughs or speaks, making it highly transmissible in crowded areas like prisons or shelters.
Certain groups are more susceptible to developing TB, such as people with alcohol use disorder, smokers, or those living with HIV. Testing for TB involves a skin or blood test, with further confirmation needed if positive. Depending on the stage of TB, different specialists such as infectious disease experts or pulmonologists may be involved in treatment.
Treating TB significantly improves outcomes, with most cases being curable if the full course of antibiotics is followed. This involves taking multiple drugs for several months. Not completing treatment or improper use can lead to drug-resistant TB. MDR TB requires a much longer treatment period and can have more severe side effects.
Staying on track with medication is crucial, with tools like medicine trackers or directly observed therapy (DOT) available to ensure compliance. Those at high risk for TB, particularly after international travel, should test and treat promptly to prevent an active disease. Isolation might be required by law for those with TB until they are no longer infectious.
Currently, there is no completely effective vaccine against TB, although efforts are underway globally to develop one. People with conditions like HIV are more vulnerable to TB, which is the leading cause of death for individuals with HIV. Without treatment, TB can cause severe health issues and spread to other organs, making early diagnosis and treatment essential for controlling the disease and preventing complications.
