Truth and myths about tuberculosis
Tuberculosis is a serious infectious disease, the development of which is caused by mycobacteria (Koch's bacillus). The disease has been known since ancient times. For a long time, the fight against him remained ineffective. Often the disease affected entire families, the mortality rate from it was very high. This has led to the emergence of many misconceptions about the infectiousness and the possibility of curing tuberculosis.
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Ways of infection and specificity of the course of tuberculosis
Today, about a third of the world's population is infected with Koch's bacilli - which does not mean that all these people are sick. In fact, pathological processes develop only in 5-7% of those infected. The reason is that a normally functioning immune system is quite capable of keeping the causative agent of the disease under control and not allowing it to harm the body. But if the immune system weakens, the bacillus has the opportunity to multiply, destroy tissues and poison the body with the products of its vital activity. The following factors contribute to the development of an active pathological process:
- malnutrition, an unbalanced diet low in protein and vitamins;
- physical and emotional overwork;
- stress;
- constant stay in a room with a poor microclimate (unventilated, inaccessible to sunlight);
- the presence of chronic ailments (gastric ulcer and duodenal ulcer, diabetes mellitus, etc.);
- frequent colds;
- bad habits (nicotine, alcohol or drug addiction).
The risk of contracting tuberculosis is very high for people living in uncomfortable premises, in overcrowded and unsanitary conditions.
The danger of infection with the Koch bacillus is also that this microorganism multiplies rather slowly, for a long time without showing itself in any way. In addition, mycobacterium is extremely resistant to the negative effects of the external environment (heat, cold, humidity). In ordinary house dust, it can survive for several years. Once in an organism that has a properly functioning immune system, the pathogen often does not die, but goes into a “dormant” state and can resume active life when suitable conditions arise.
No less dangerous is that the signs of the onset of the disease do not greatly disturb people who have contracted tuberculosis. When the pathological process is already underway, a person is observed:
- night sweats;
- decreased performance;
- weakness;
- a steady increase in body temperature (no higher than 37.5 ° C);
- decreased appetite, weight loss;
- mild, but obsessive cough.
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Such sensations can easily be mistaken for the result of overwork or a mild cold. Patients often delay the visit to the doctor and start the disease. In the future, chest pains and symptoms of an allergic reaction to toxins secreted by bacilli appear. At this point, the lung tissue is already undergoing destruction and the patient needs serious medical treatment.
The most common myths about tuberculosis
Widespread misconceptions are associated with the degree of infectiousness of the disease, and with the prospects for its cure. The following statements are most common:
- "Tuberculosis is a disease of the poor and homeless." This is both true and not true. It is clear that for people who are poorly nourished, live in unsanitary conditions and lead an asocial lifestyle, the possibility of infection is very high. But this does not mean that each of them will get sick or become a carrier of mycobacteria. On the other hand, a successful person, who works a lot and hard, is stressed and often in public places, is also not guaranteed health, since his immune system is not necessarily in perfect condition. It is not protected a priori either from infection or from the development of an illness;
- "Every person who gets the bacillus Koch gets sick." This is not true. The pathological process develops in 5-7 people out of 100 carriers;
- "All patients with tuberculosis are contagious." The statement is not only unfair, but also quite cruel. In fact, only people suffering from an open form of pulmonary tuberculosis are acutely infectious. But even with constant close proximity to such a patient, for a person with a high immune status, there is a chance to stay healthy;
- "Tuberculosis is an exclusively pulmonary disease." In 95% of cases, Koch's bacillus affects the respiratory system. However, there are also extrapulmonary forms of the disease. In these cases, the genitourinary system, gastrointestinal tract organs, joints and bones, lymph nodes, eyes, skin or central nervous system (tuberculous meningitis) are affected;
- "Tuberculosis is incurable." In a sense, this is true. Despite the fact that today about 40% of people suffering from this disease, as a result of treatment, they fully recover their working capacity, mortality from tuberculosis is still high. In addition, even cured patients should be observed by a phthisiatrician for several years, since it is impossible to remove all Koch's bacilli from the body and the likelihood of a relapse is not excluded.
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Many believe that the widespread spread of tuberculosis is now possible only in developing countries, and in the most civilized countries it is almost defeated. In fact, any drop in living standards and a decrease in attention to anti-epidemic measures leads to a surge in morbidity and an increase in mortality from this disease. This happened, for example, in Ukraine, where tuberculosis became so widespread that in 1995 WHO was forced to recognize this country as an epidemic zone.
Tuberculosis treatment: successes and challenges
As with many other diseases, the success of curing tuberculosis depends on timely diagnosis, and this is far from easy. At the onset of the disease, the presence of the pathogen in the body may manifest itself in the form of a positive reaction to the Mantoux test. Unfortunately, this also happens in the absence of a tuberculous process, and on the contrary, in some cases, patients have a negative reaction. The most informative diagnostic methods (fluorography, lung X-ray, sputum examination) give reliable results only at later stages. Extrapulmonary tuberculosis is even more difficult to diagnose. As a result, adequate treatment is often started late.
Anti-tuberculosis therapy is carried out with the help of a whole complex of drugs that are active against the Koch bacillus, but the treatment is not always successful. The fact is that mycobacteria are capable of developing resistance to antibiotics. Now cases of infection with such "unkillable" strains are increasingly common. In addition, taking anti-TB drugs is not a pleasant activity. Many of these drugs are highly toxic. As a rule, they are taken in parallel with hepatoprotectors and agents that protect the stomach and intestines, but side effects still occur quite often.
Usually, drug therapy for pulmonary tuberculosis gives a result no earlier than six months later, and patients with extrapulmonary forms of the disease can feel relief only after 9-12 months. Diseases such as osteoarticular tuberculosis require surgery in a significant percentage of cases.
For the restoration of working capacity, it is very important that the patient receives enhanced nutrition. His diet should contain a sufficient amount of animal protein, vitamins and trace elements. After the main course of therapy, patients with tuberculosis are shown a long-term spa treatment.
The importance of preventing tuberculosis
The main preventive measure against tuberculosis is the BCG vaccine. It is carried out to newborns at the age of 3-7 days, and then (in the absence of contraindications) to children of 7 and 14 years old. However, this procedure can also have a negative effect. Some experts believe that it was the widespread use of BCG vaccination that led to the emergence of drug-resistant varieties of mycobacteria. It should be noted that the vaccinated people also get sick with tuberculosis. This means that such prevention does not create reliable immune protection against the disease.
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Tuberculosis refers to diseases, the spread of which is associated with social factors. Therefore, it is very important that the state takes an active part in the fight against the disease. In the 90s of the XX century, the control of the authorities over the work of anti-epidemic services weakened. In combination with an increase in the number of socially disadvantaged migrants from neighboring countries, this gave Russia a tangible surge in the incidence of tuberculosis and an increase in mortality. Now the situation has improved somewhat, but this disease in our country is by no means defeated.
For the prevention of tuberculosis, the growth of the welfare of the entire state and each of its citizens is of primary importance. In addition, it is necessary to instill in people from childhood a culture of respect for personal safety. This concept includes adherence to sanitary and hygienic standards, the habit of proper nutrition and a healthy lifestyle, and a careful attitude to one's own health. If each of us regularly undergoes diagnostics (at least do fluorography), consult a doctor in time if we feel unwell and follow his instructions, the risk of the spread of diseases such as tuberculosis will significantly decrease.
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Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".
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