Tuberculosis (TB) is an infectious disease caused by bacteria that primarily attack the lung. Anyone can get TB but those with suppressed immunity (HIV/AIDS, diabetes, chemotherapy) are most at risk. 90 percent of infected people do not get ill because their body’s defences cope. Symptoms may include cough, weight loss, fever, night sweats, and chest pain. Diagnosis is usually confirmed by Chest X-Ray appearance and sputum (mucous) testing for the presence of the bacteria. Treatment uses multiple antibiotics over a long period (from 3-9 months) and is usually effective but compliance is important to prevent resistance (where bacteria do not respond to treatment) and complications.

TB is something of a “dread disease” in the sense that people are afraid of it. It is generally known that TB can be quite serious and even fatal, and it is also known that TB spreads from person to person. This leads people to fear TB and to fear those who have or might have TB. This is logical and rational to a point, and some care is needed around a patient with TB. But the fear is often excessive and people can behave somewhat irrationally in many instances. A few key points can be made here:

  • Most healthy people do not actually develop TB disease even when exposed to TB germs. A normal healthy immune system will fight-off and or contain TB germs in something like 90% of cases.
  • In most cases TB treatment is extremely effective and most patients will not be infectious within a few weeks of starting treatment. Even though the recommended treatment duration is several month, the infectious period is usually much shorter.
  • Those with weakened immunity (small children, the elderly, those with serious medical conditions like diabetes and HIV, those on chemotherapy) are more at risk of catching TB and developing serious TB disease. These people should be extra careful around TB.
  • TB is not a “dirty” disease any more than any other infectious disease. There may be an association with poverty because of overcrowding and poor nutrition in some regions, but the reality is that TB can infect and affect the wealthy and the poor, the young and the old, those of all races and all cultures. TB is not prejudiced regarding who it infects.
  • TB patients should try to avoid open coughing and or sneezing (use a paper handkerchief).
  • It seems likely (although opinions vary and solid evidence is limited) that mask wearing (by a TB patient and by those in close contact) during the initial period of treatment (ask the doctor but perhaps the first month or so) may be helpful. Since it is unlikely to be harmful and since the stigma once associated with masks has been reduced after the COVOD-19 pandemic, this seems like sensible advice.

TB is certainly a serious medical condition. But it is less dangerous than many people think. Treatment is generally very effective. Most TB patients can safely return to normal family and work life as soon as they feel able to and or have been on proper treatment for a month or so.

Written by Dr Colin Burns