Tuberculosis - TBC

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Tuberculosis - TBC
Tuberculosis - TBC
Video: Tuberculosis - TBC
Video: Tuberculosis 2023, February


Tuberculosis (TB, consumption) is an infectious disease that is widespread worldwide. Pathogens are mycobacteria that are primarily transmitted from person to person (droplet infection). Other transmission routes (e.g. via food such as unpasteurized milk) are less common. In the majority of cases, the bacteria settle in the respiratory tract and lead to pulmonary tuberculosis. However, all other organs can also be affected (organ tuberculosis).

Tuberculosis is one of the most important bacterial infections in humans, it is the most common bacterial infectious disease that leads to death. The WHO reported around ten million new cases worldwide in 2016, around 1.7 million of which were fatal.


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Pathogen: the most important pathogen for humans is Mycobacterium tuberculosis; there are also numerous other types of bacteria that can cause tuberculosis. The source of infection is primarily the sick person.

Distribution: worldwide, especially in developing countries and crisis areas. Around 80 percent of all new cases of tuberculosis occur in Southeast Asia and Africa.

Distribution map

The disease hardly ever occurs in tourists, but not infrequently in so-called VFRs (“visiting friends and relatives”). In Austria, most new cases are brought in through migration from countries with a high incidence of tuberculosis (e.g. Eastern Europe, Africa, Southeast Asia). According to Statistics Austria, 517 cases of contagious tuberculosis were reported in Austria in 2016.

About a third of the world's population is infected with tuberculosis bacteria, but the disease only breaks out in five to ten percent of them. (Small) children and young people and people with a weakened immune system are particularly at risk. This particularly affects HIV-positive people: in many countries around the world, tuberculosis is the most common cause of death for HIV patients.

Transmission: Droplet infection (inhalation of infected droplets of saliva) directly from person to person. Since cattle can also get tuberculosis, (unpasteurized) raw milk used to be a common source of infection in Western Europe and is still a common source of infection in parts of the world.

Incubation period: several weeks to months; the disease can break out years after infection.

Symptoms: The course of tuberculosis depends on the immune system:

After infection, the bacteria initially trigger local inflammatory reactions (in pulmonary tuberculosis, within the lung tissue). The local lymph nodes are also involved. The symptoms are unspecific, such as weakness, tiredness, a slight fever, reduced performance, weight loss; in the case of pulmonary tuberculosis, cough and breath-dependent pain are typically added. The symptoms can be mistaken for a flu-like infection. Such symptoms that appear immediately after infection are called primary tuberculosis.

If the immune system is intact, it can contain the infection and keep the bacteria in check. Small nodules ("tubercles") form in which the bacteria are encapsulated. This prevents them from spreading further. In 90 percent of those affected, the infection remains at this stage for life and is sometimes not noticed. One speaks of latent ("dormant") tuberculosis.

If the immune system is weakened at the time of infection, the bacteria cannot be adequately encapsulated and trigger active tuberculosis. This is also possible after a primary infection that has already passed through: the pathogen can survive in encapsulated herds in the body and lead to the outbreak of tuberculosis decades after the infection. One then speaks of post-primary tuberculosis. The highest risk of developing active tuberculosis is found in small children (half of all affected children fall ill in the first year after infection) and people with a weakened immune system (e.g. due to additional diseases such as HIV, cancer, diabetes, malnutrition or from taking certain medications).

The pathogens initially spread locally, in the case of pulmonary tuberculosis over large areas over other lung sections. Persistent feeling of illness with fever, cough, (bloody) sputum and weight loss ("consumption"!) Are the consequences. If a focus of inflammation breaks open and the pathogens get into the airways, what is known as open tuberculosis occurs: At this stage, those affected are highly infectious because they release the bacteria into the environment with their breath (especially when coughing). Open tuberculosis is notifiable.

If left untreated, the TB bacteria can continue to multiply and attack other organ structures. If they get connected to the vascular system, they can spread through the bloodstream and lead to the particularly dangerous form of miliary tuberculosis. Many individual foci of inflammation develop within the body (e.g. in the pleura, peritoneum, intestine, spleen, kidneys, skin, etc.). Those affected suffer from a strong feeling of illness, coughing, shortness of breath, high fever, pain, and neurological failures. It is particularly threatening when the bacteria trigger tuberculous meningitis (meningitis) or blood poisoning (sepsis). Miliary tuberculosis is life threatening and must be treated immediately.

The timely detection of the sick and extensive environmental examinations are the only ways to get this disease under control.

Diagnosis: In addition to the symptoms, special laboratory tests are used to confirm the diagnosis; in the case of pulmonary tuberculosis, additional x-ray examinations.

Therapy: With timely combination therapy, the patient can usually be cured. It is carried out in pulmonology departments or outpatient clinics in hospitals and extends over several months. However, there is an increased incidence of (highly) resistant tuberculosis for which no effective drugs are available.

Prevention: There is a tuberculosis vaccine (BCG vaccine) that has been used in Europe for a long time. Today, however, the WHO recommends that no general TB vaccination should be carried out in countries with a tuberculosis risk of less than 0.1 percent, particularly because of their high rate of side effects. There is currently no approved tuberculosis vaccine available in Austria.

In many countries around the world, this vaccination is still a mandatory vaccination. Some high-risk countries require proof of BCG vaccination for infants and children upon entry. For these rare exceptional cases, you can contact the tuberculosis welfare office responsible for your place of residence.

The BCG vaccination does not protect against infection, but can prevent dangerous miliary tuberculosis and tuberculosis meningitis. In high-risk countries, the WHO recommends vaccinating children as soon as possible after birth to protect them from serious disease.

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