Mycobacterium tuberculosis is fatal

Tuberculosis is contagious and life threatening

Tuberculosis (TB) is a contagious infectious disease that can be fatal. In most cases it affects the lungs, but the bacteria can also spread to other organs and cause serious damage. An overview.

Tuberculosis is tricky: the bacteria can stay in the body for many years without anything happening - but then multiply, mostly undetected at first. If left untreated, it can be chronic and lead to serious secondary diseases. Typical symptoms include cough, sputum, weight loss, and a mild fever.

the essentials in brief

  • Tuberculosis is a droplet infection. The bacteria get into the air through tiny amounts of saliva when speaking, coughing or sneezing. Then they penetrate the mucous membranes.
  • Worldwide, three people die of TB every minute, and around ten million people were newly infected in 2017 alone, according to the World Health Organization (WHO).
  • In Germany, the numbers are declining slightly, but the all-clear has not been given: According to the Robert Koch Institute (RKI), around 5,500 patients contracted tuberculosis in this country in 2017, around 6,000 in 2016 and around 5,800 in 2015.
  • The disease mostly affects the lungs, but other organs can also be affected, such as the brain, intestines, kidneys and urinary tract, or the lymphatic system.
  • TB bacteria can lie dormant in the body for many years without being noticeable.
  • If treated long enough and professionally, tuberculosis will often heal well, especially if detected early.

In 80 percent of cases, the tuberculosis bacteria attack the lungs. We present other tuberculosis diseases here: Tuberculosis can affect almost any organ.

Symptoms of tuberculosis

As long as the bacteria are dormant, there are no signs of infection. In five to ten percent of cases, however, the disease breaks out. Foci of inflammation form in the lungs and the surrounding lymph nodes enlarge. Those affected do not notice anything for a long time, because the process only develops slowly.

Later the bacteria spread in the lungs and bronchi, the tuberculosis is now open. Affected people often cough, initially dry, later a yellowish-green, slimy sputum forms, which may also contain blood (hemoptysis). At this point at the latest, a doctor should be consulted immediately.

Pain, fever, and sweating

Patients are highly contagious at this stage. Other symptoms include chest pain and pressure, accompanied by a slight fever and night sweats. Affected people suffer from tiredness and exhaustion, they lose appetite and weight.

How contagious is tuberculosis?

Anyone who has contact with people who suffer from open tuberculosis can easily become infected. The bacteria spread as droplet infection through the air they breathe, mostly through frequent coughing by the patient. An infection is also possible through speaking, sneezing, touching or skin injuries.

In some regions of the world, the risk of infection is particularly high, so travelers should be careful here. According to the Tropical Institute, the risk areas include Southeast Asia, Africa, the western Pacific region and the former Soviet republics.

There is an increased risk of contracting tuberculosis in these regions. (Source: WHO)

Who is particularly at risk?

Healthy people with a strong immune system can get infected, but the immune system usually keeps the bacteria in check. People with a weak immune system are at risk, for example patients with a chronic disease such as diabetes mellitus, HIV or kidney failure. Even those who take cortisone, cell toxins or the immune system suppressants (immunosupressants) on a long-term basis, are more likely to develop TB.

Other risk groups are smokers and malnourished, alcoholics, the homeless and drug addicts. Babies and toddlers up to four years of age are also often affected, as are refugees. The risk of disease increases with age.

Different stages of tuberculosis

Anyone who has become infected with tuberculosis bacteria does not notice any symptoms at first. As long as the immune system prevents the pathogens from breaking out further, nothing else happens. Doctors then speak of latent tuberculosis. If the defense against the TB bacteria fails, up to ten percent of patients develop what is known as primary tuberculosis after an average of seven weeks.

The bacteria can get to the surrounding lymph nodes via the lymphatic system or to other organs via the bloodstream. Inflammation develops, usually in the lungs and nearby lymph nodes.

Defense cells enclose the pathogens

The foci of inflammation are, so to speak, fenced off by the immune cells: nodules form in which the pathogens are trapped and thus cannot cause any damage. Over time, these tubercles, also known as granulomas, healed. Doctors call this form of the disease closed tuberculosis.

However, it can also happen that the bacteria break through the enclosure. In the case of such post-primary TBC, the immune system has lost and the disease breaks out. 80 percent of the pathogens affect the lungs. However, any other human organ can also be affected.

Bacteria collect in the liquid

If the TB bacteria get out of hand and multiply, tuberculosis is open: The pathogens collect in fluid in caves, so-called caverns, which, among other things, get into the tubes of the lungs and then spread into the air via coughs.

Bacteria Mycobacterium tuberculosis (Source: Thinkstock by Getty-Images)

Galloping consumption

This form of the disease is particularly dangerous: the affected areas of the lungs are inflamed and this process progresses rapidly. The lung tissue becomes yellowish and crumbly, which doctors also call "cheese formation", and dies. The tissue partially liquefies and then scatters. The disease is often fatal.

How does the doctor recognize tuberculosis?

The symptoms are mostly non-specific, but there are a number of tests that medical professionals can use to detect the disease.

  • The doctor's talk: The doctor asks about typical symptoms such as cough, fever, sweating or weight loss. He will also want to know whether there has been contact with sick people, trips to risk areas, previous illnesses or medication that is being taken.
  • Physical examination: The lungs are tapped and listened to. The doctor also examines the skin.
  • Tuberculin skin test (THT): A syringe brings a tiny amount of part of the pathogen under the skin. If the patient already carries TBC bacteria, he also has antibodies, which now react with reddening at the puncture site.
  • IGRA (interferon gamma release assay): This blood test detects proteins that are produced in TBC. They are called interferon gamma.
  • Proof of the causative agent: TBC bacteria can be detected directly in brain water, urine, sputum, gastric juice and tissue samples from the lungs and lymph nodes.
  • roentgen: Foci of inflammation can be seen as shadows.
  • Computed tomography (CT): CT images can provide information for affected parts of the body outside the lungs.

If a doctor has diagnosed tuberculosis, he must report the case to the health department.

How is tuberculosis treated?

Today, tuberculosis is basically curable. The therapy consists of a combination of different antibiotics that are specifically effective against TB pathogens. The most common antituberculotics are in particular rifampicin, isoniazid and streptomycin. If a patient does not tolerate these agents or is resistant to one or more, kanamycin, cycloserine or tetracyclines are also administered as an alternative.

The therapy lasts at least six months, sometimes longer. It is important to take the medication regularly and continuously so that the tuberculosis does not recur. Some of the drugs have serious side effects and can damage the eyes, ears, liver, nerves and other organs. Close control during therapy is therefore necessary. After three weeks of combination therapy, patients are usually no longer contagious.

What are the chances of recovery from tuberculosis?

If the disease is treated in good time and for a long enough time, the chances of recovery are usually good. There are complications with resistance and with patients who are already weakened and / or suffer from other diseases. If the tuberculosis is severe, lung bleeding can occur, as can life-threatening blood poisoning or collapsed lungs.

Is there a vaccination against tuberculosis?

By the end of the 20th century (1998) there was a tuberculosis vaccination using a weakened mycobacteria strain. Since 1998, immunization against tuberculosis has not been recommended by the Standing Vaccination Commission (STIKO) at the Robert Koch Institute (RKI) and is no longer approved in Germany. Firstly because the risk of infection is low in this country, and secondly because of some undesirable side effects. In Germany around 5,500 people fall ill with tuberculosis every year, and a relatively constant 100 patients die from the disease every year, according to the RKI.

In other countries with a higher incidence rate, the vaccination is still available. However, vaccination is not recommended when traveling to countries with high levels of tuberculosis. However, if you are unsure whether you have been infected after your trip, you can have a tuberculin test carried out.

Important NOTE: The information is in no way a substitute for professional advice or treatment by trained and recognized doctors. The contents of t-online cannot and must not be used to independently make diagnoses or start treatments.