Tuberculosis or TB was very common in the U.S. before antibiotics were developed. At that time, it was called Consumption and was a major cause of death. It is still a common cause of death in developing countries. It is caused by the tiny, slow growing bacteria Mycobacterium tuberculosis. The bacteria lodges in the lungs and can become active immediately or wait months or years to emerge as an active infection. It is terminal if left untreated.
TB is one of the few diseases that are spread in the air from the sick person coughing or breathing. The bacteria ride in the air as tiny droplets that may stay airborne for hours. It is spread by inhaling these droplets. Because of this, patients with known TB must have special isolation precautions.
Active infections of TB can come from a new exposure to the bacteria or from reactivation of the disease from an old exposure.
People with weak immune systems are more likely to have active TB. This would include the elderly, children, people with HIV/AIDS, people with diabetes, or anyone who has been "worn down" from lack of sleep or lack of proper nutrition.
The risk of Tuberculosis (TB), especially among children, increases with the following risk factors: having a family history of tuberculosis infection going back two to three generations; having traveled abroad or having been exposed to foreign visitors; having contact with HIV-infected persons; having contact with current or previous prison inmates; and living in high-risk areas.
Pulmonary TB is often so nearly asymptomatic (showing no signs or symptoms) that the patient may deny all symptoms except "not feeling well". However, the following symptoms are possible:
Diagnosis will almost certainly require lab tests and X-rays. It shares symptoms with many other respiratory infections. Since TB is not extremely common in the United States at this time, suspect other problems before you suspect TB.
The following would increase your suspicion of TB:
As with most things, prevention is best – especially since TB can be (extremely) hard to treat. If you are in the close company of others suspected of being at risk for TB, everyone should be screened annually for TB. The test is cheap and easy. If someone in your group has been exposed, REQUIRE them to go through the full course of treatment, which can take up to 9 months.
When Dr. Thomas Addison first described this disease in London in 1855, the most common cause was tuberculosis. This remained the leading cause until the middle of the twentieth century when antibiotics progressively reduced TB's incidence. TB is nevertheless still a possible cause.
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