Tuberculosis

Just last month, tuberculosis (TB) was found in Long Beach. 14 cases were detected, with nine people hospitalized and one death. What is going on with tuberculosis?

In 1935, my grandfather died of tuberculosis, leaving behind a widow with three small children. In the 1940’s, antibiotics provided a major breakthrough for treatment. That was a very long time ago, but it may surprise you that since 2020, diagnosed cases in the United States have actually risen every year, after 27 years of decline. (Part of this may be due to the pandemic reducing access to diagnosis, care, and treatment). It is estimated that during 2022 alone, nearly 11 million men, women and children worldwide contracted TB, and of them, 1.3 million died. This is despite the fact that, for the most part, TB is now curable with antibiotics, and preventable!

TB is an infectious bacterial disease, which most often affects the lungs. Mycobacterium tuberculosis spreads through the air when infected people cough or sneeze. Some 25% of the global population has likely been infected with TB bacteria (latent TB), and about 5–10% of them will eventually get symptoms and develop the disease (active TB). Babies and children are at higher risk, and in some countries where the disease is more common, a vaccine is available for them.

Latent TB is not contagious and has no symptoms. Active TB symptoms may be mild for many months, making it easy for it to be unknowingly spread among family members, classmates, co-workers, and friends. Symptoms of active TB include chronic cough, coughing up blood or sputum, chest pain, fatigue, muscle weakness, loss of appetite, weight loss, chills, fever, and night sweats. Symptoms depend on where in the body TB becomes active - it also can affect the kidneys, brain, spine and skin.

Certain conditions can increase one’s risk for tuberculosis, including diabetes, a weakened immune system (for example, HIV or AIDS), being malnourished, and tobacco use.

The TB bacteria can be detected by blood or skin tests, or sputum samples. A chest X-ray will show infection if it is located in the lungs. Treatment for active cases (as well as for some latent cases) consists of three to nine months of antibiotics. Unfortunately, in some cases, TB has become drug resistant.

Timely diagnosis and treatment are essential to cure the disease and to limit its spread. Prevention is crucial, and includes:

• Limiting contact with an infected person.

• Access to medication for known cases

• Regular testing of healthcare workers or employees at nursing homes, correctional facilities, and such

• Testing for TB following travel from regions with higher rates, and prompt screening after a known exposure

Yes, tuberculosis is a very personal disease for me, and I find it astonishing that even with antibiotics, patients are still dying of it 90 years later. With more rapid testing, effective treatment, and a better vaccine, one day it will hopefully be eradicated.