30% of people infected with tuberculosis… 10% of people infected with Mycobacterium tuberculosis develop active tuberculosis
90% prevention of active tuberculosis when latent tuberculosis is treated
Take 3 or 4 medications for 6 to 9 months… Do not stop arbitrarily
Source – Clip Art Korea
If you ask the question, ‘What is the most frightening infectious disease right now?’, many people will answer Corona 19. However, in fact, ‘tuberculosis’ is a terrifying infectious disease that has been taking human lives for a long time. Since tuberculosis was first identified in 1882, approximately one billion people have died from tuberculosis.
Worldwide, in 2020 alone, about 9.87 million people with tuberculosis were diagnosed, and about 1.5 million people died from tuberculosis. According to data from the Korea Tuberculosis Association, there were 22,904 tuberculosis patients in Korea last year, and 1,356 patients died from tuberculosis that year. Among the member countries of the Organization for Economic Cooperation and Development (OECD), Korea has the highest tuberculosis incidence rate and the third highest mortality rate. The level of eradicating tuberculosis remains in the underdeveloped countries.
◆What is tuberculosis?
Tuberculosis is a disease caused by the invasion of bacteria called Mycobacterium tuberculosis. Mycobacterium tuberculosis mainly infects the lungs, but it can occur in many parts of the body, including lymph nodes, abdomen, bones, joints, pleura, kidneys, and nerves.
When Mycobacterium tuberculosis infects the lungs and causes inflammation, pneumonia occurs, which is called ‘pulmonary tuberculosis’. The transmission of Mycobacterium tuberculosis occurs only through patients with pulmonary tuberculosis. While COVID-19 is transmitted through direct contact or droplets, tuberculosis is transmitted through the air. Mycobacterium tuberculosis, released through the cough and sputum of a pulmonary tuberculosis patient, floats in the air and enters the lungs of others through breathing, causing infection.
Even if tuberculosis bacteria enter the lungs, not everyone will develop tuberculosis. About 30% of people who come in contact with tuberculosis patients become infected with Mycobacterium tuberculosis. Not everyone infected with tuberculosis develops active tuberculosis. About 10% of infected people develop tuberculosis, which is called ‘active tuberculosis’.
Individual immune function plays an important role in the development of active tuberculosis.
Professor Jang Jong-geol of the Department of Respiratory Allergy at Yeungnam University Hospital explained, “About 50% of active tuberculosis patients develop within 1 to 2 years after contact, and the remaining 50% develop when immunity declines after 10 years or more.”
tuberculosis bacteria. Clip Art Korea Images
latent tuberculosis
Latent tuberculosis is a condition in which bacteria are present in the body but are inactive after being infected with tuberculosis, and most have no symptoms and no contagiousness. However, if the immune system is weakened, the tuberculosis bacillus may multiply and become active, resulting in active tuberculosis. With treatment, the development of active tuberculosis can be prevented by 90%.
The diagnosis of latent tuberculosis is made through a tuberculin skin test and an interferon gamma blood test. The skin reaction test is a test that measures the reaction that appears on the skin after 48 to 72 hours by injecting the tuberculin reagent into the inner skin of the arm.
Active tuberculosis
Active tuberculosis is a condition in which the Mycobacterium tuberculosis enters the body and causes disease. It has symptoms and is highly contagious. Tuberculosis has a variety of symptoms, but in the early stages of tuberculosis, there may be no symptoms. The most common symptom is cough, and various symptoms such as low fever, weight loss, hemoptysis, chronic fatigue, and chest pain may appear.
In most cases, the symptoms of a cold improve on their own within 10 days after the onset of symptoms.
Prof. Jang Jong-geol emphasized, “If the diagnosis is delayed, not only will the tuberculosis bacteria spread, but also your pneumonia may worsen, making it difficult to treat or leave sequelae after treatment.”
Jang Jong-geol, Professor, Yeungnam University Hospital
Diagnosis and treatment of tuberculosis
The most important tests in the diagnosis of tuberculosis are sputum examination and chest radiography. Among these, a sputum tuberculosis bacillus test must be performed to confirm the diagnosis of tuberculosis. If there is no sputum in some patients, bronchoscopy using a bronchoscope can be performed to replace sputum examination.
There are three types of sputum tuberculosis test: ▷ smear test ▷ genetic test ▷ culture test. The final diagnosis of tuberculosis is a culture test, but it takes 2 to 8 weeks to obtain a result, so in many cases, tuberculosis treatment is started through smear and genetic testing.
In order to treat tuberculosis, it is necessary to take many types of drugs for a long period of time compared to other bacterial pneumonia. Mycobacterium tuberculosis grows slowly and is resistant to drugs, so it is common to take 3 to 4 drugs for 6 to 9 months.
Although tuberculosis has a long treatment period, the contagiousness to others mostly decreases two weeks after tuberculosis treatment. If the tuberculosis drug is taken well, the treatment success rate is about 90%, but it should be kept in mind that drug-resistant bacteria may develop if the drug is taken irregularly.
In particular, multidrug-resistant tuberculosis, which is simultaneously resistant to two key drugs (isoniazid and rifampin), needs to be treated for at least 20 months, and the treatment success rate is low due to many drug side effects. In order to increase the success rate of tuberculosis treatment and prevent multidrug-resistant tuberculosis, the patient should consult with a doctor without stopping voluntarily even if it is difficult to take the drug.
To prevent tuberculosis, newborns should be vaccinated against BCG within 1 month of age. In addition to regular intake of sufficient nutrition and moderate exercise, you should constantly manage your health, such as excessive drinking, overwork, and reducing stress. Since uncontrolled diabetes increases the incidence of tuberculosis, attention should be paid to glycemic control.
Professor Jang said, “TB is an infectious disease that has been taking human lives and causing social and economic losses longer than COVID-19. “I think it will help prevent tuberculosis.”
Help Jang Jong-geol Professor of Respiratory Allergy at Yeungnam University Hospital
