The truth and myths about tuberculosis

Tuberculosis – a serious infectious disease which development is caused by mycobacteria (Koch's bacilli). The illness is known from an extreme antiquity. Long time fight against it was considered as ineffective. Quite often the disease affected the whole families, and mortality from it was very high. It became the reason of emergence of a set of delusions concerning transmissibility and a possibility of treatment of tuberculosis.

Ways of infection and specifics of a course of tuberculosis

Today Koch's bacilli infected about a third of the population of Earth. From this does not follow that all these people are sick. Actually pathological processes develop only at 5-7% infected. The fact that normally functioning immune system is quite capable to keep the causative agent of an illness under control is the reason of this phenomenon and not to allow it to harm an organism. But if immunity weakens, the bacillus has an opportunity to breed, destroy fabrics and to poison an organism with products of the life activity. Development of active pathological process is promoted by the following factors:

• Malnutrition, unbalanced food with the low content of proteins and vitamins;
• Physical and emotional overfatigue;
• Stresses;
• Constant stay in the room with a bad microclimate (not aired, unavailable to a sunlight);
• Existence of chronic illnesses (peptic ulcer of a stomach and duodenum, diabetes mellitus etc.);
• Frequent colds;
• Addictions (nicotine, alcohol or drug addiction).

The risk to ache with tuberculosis is very high for the people living in the uncomfortable rooms in the conditions of density and insanitary conditions.

Danger of infection with Koch's bacillus is connected also with the fact that this microorganism breeds quite slowly, long time without proving in any way. Besides, the mycobacterium is extremely steady against negative impacts of external environment (heat, cold, humidity). In usual house dust it can keep viability within several years. Having got to the organism having correctly functioning immune system, the activator quite often does not perish, and passes into the "dozing" state, and can resume active life activity at emergence of suitable conditions.

Not less dangerously to the fact that signs of the beginning of a disease not really strongly disturb the people who caught it. When pathological process already goes, at the person are observed:

• Night perspiration;
• Decrease in working capacity;
• Weakness;
• Steady fervescence (it is not higher than 37,5 degrees);
• Loss of appetite, loss of weight;
• Weak, but persuasive cough.

It is easy to take these feelings for a consequence of overfatigue or a slight cold. Patients often delay a visit to the doctor and start an illness. Further there are stethalgias and symptoms of allergic reaction to the toxins emitted by bacilli. At this moment of tissue of lungs are already exposed to destruction, and the patient needs serious drug treatment.

The most widespread myths about tuberculosis

Widely occurring delusions are connected both with degree of transmissibility of a disease, and with perspectives of its treatment. Most often the following statements meet:

• "Tuberculosis – a disease of beggars and homeless". It both so, and not so. It is clear, for people who badly eat live in insanitary conditions and lead an asocial life, an opportunity to catch it is very high. But from this does not follow that each of them will get sick or will become the carrier of mycobacteria. On the other hand, the successful person, is a lot of and hard working, subject to stresses and often happening in public places, cannot be guaranteed neither against infection too, nor against development of an illness as its immune system at all not necessarily is in perfect tune;
• "Each person to whose organism Koch's bacillus got gets sick". It is incorrect. Pathological process develops at 5-7 people from 100 carriers;
• "All TB patients are infectious". Statement not only unfair, but also quite cruel. Actually, only the people suffering from an open form of pulmonary tuberculosis are highly infectious. But even at the constant close neighbourhood with such patient for the person with the high immune status there is a probability to remain healthy;
• "Tuberculosis – exclusively pulmonary disease". In 95% of cases Koch's bacillus strikes a respiratory organs. However there are also extra pulmonary forms of an illness. In these cases the urinogenital system, bodies a GIT, joints and bones, lymph nodes, eyes, skin or TsNS (tubercular meningitis) suffer;
• "Tuberculosis is incurable". Somewhat this is true. In spite of the fact that today at about 40% of the people having this disease as a result of treatment working capacity is completely recovered, tuberculosis mortality is still high. Besides, even the recovered patients within several years have to be observed at the phthisiatrician as it is impossible to remove all bacilli of Koch from an organism, and the probability of a palindromia is not excluded.

Many consider that wide circulation of tuberculosis is possible only in developing countries now, and it is already almost won the most civilized states. Actually, any falling of the standard of living and decrease in attention to anti-epidemic actions leads to surge in incidence and growth of mortality from this illness. So it happened, for example, in Ukraine where tuberculosis so extended that in 1995 WHO was forced to recognize this country as epidemic zone.

Treatment of tuberculosis: progress and problems

As well as for many other diseases, for tuberculosis success of treatment depends on timely diagnosis, and it is not always simple. In an onset of the illness existence in an organism of the activator can be shown in the form of positive reaction to Mantoux reaction. Unfortunately, it is possible also in the absence of tubercular process, and, on the contrary, in certain cases at patients negative reaction is observed. The most informative diagnostic methods (fluorography, X-ray of lungs, a phlegm research) yield reliable results only at later stages. To diagnose extra pulmonary forms of tuberculosis even more difficultly. It often leads to the fact that adequate treatment is begun with delay.

Antitubercular therapy is carried out by means of the whole complex of drugs, active concerning Koch's bacillus, but treatment not always happens successful. The matter is that mycobacteria are capable to develop resistance to antibiotics. Now cases of infection such "the strains which are not killed" meet even more often. Besides, reception of antitubercular drugs – occupation not from pleasant. Many of these drugs are highly toxic. As a rule, they are accepted in parallel with the gepatoprotektor and means protecting a stomach and intestines, but side effects all the same arise quite often.

Usually medicinal therapy of pulmonary tuberculosis yields result not earlier than in half a year, and patients with extra pulmonary forms of an illness can feel simplification only in 9-12 months. Such diseases as bone and joint tuberculosis, in considerable percent of cases demand surgical intervention.

It is very important for maintenance that the patient received suralimentation. Its diet has to contain enough animal protein, vitamins and microelements. After a basic course of therapy by the TB patient prolonged sanatorium treatment is shown.

Importance of prevention of tuberculosis

The main preventive action against tuberculosis is the inoculation vaccine BTsZh. It is carried out by the newborn at the age of 3-7 days, and then (in the absence of contraindications) to children of 7 and 14 years. However this procedure can have also a negative effect. Some specialists consider that universal distribution of an inoculation of BTsZh led to emergence of kinds of the mycobacteria steady against drugs. It should be noted and the fact that also vaccinated people get sick with tuberculosis, that is such prevention does not create a reliable host defense from an illness.

Tuberculosis belongs to those diseases which spread is connected with social factors. Therefore it is very important that the state took active part in fight against an illness. In the nineties the last century control of the authorities of work of anti-epidemic services weakened. In combination with increase in number of socially unsuccessful migrants from neighboring countries it gave notable surge in incidence of tuberculosis and growth of mortality in Russia. Now the situation improved a little, but this illness is not won our country at all.

Growth of welfare of all state and each of his citizens is very important for prevention of tuberculosis. Besides, it is necessary to cultivate from the early childhood at people culture of observance of measures of personal security. This concept includes following to sanitary and hygienic norms, a habit to healthy nutrition and a healthy lifestyle, and also the attentive attitude towards own health. If each of us regularly undergoes diagnosis (at least to do fluorography), in time to see with an indisposition a doctor and to carry out his appointments, risk of spread of such diseases as tuberculosis, will significantly decrease.