Information about tuberculosis
What is TB?
TB (tuberculosis) is an infectious disease caused by Mycobacterium tuberculosis, often called bacilli. The disease develops only in response to reproduction in the human body of these microbes.
The main source of TB infection is a person who is sick with lung tuberculosis. From the respiratory tract, especially during coughing, is separated sputum containing Mycobacterium tuberculosis. Small droplets of mucus can get into the respiratory tract of a healthy person nearby. Mucus can settle on the surface of the floor or land on objects and things. The infection can get into the human body as a result of poor hygiene – for example, if you do not wash your hands after contact with handles in public transport or eating unwashed fruits and vegetables, poorly processed meat and unboiled milk.
In most cases, if a person's immune system is normal, the inhalation of tubercle bacilli leads to the disease in the active stage. To trapped in the respiratory tract mycobacteria rushes an army of cells defenders to absorb and kill the most part of pathogens. But some of mycobacteria can survive for a long time to be inactive. Thus, the "attack" pathogenic organisms on the body remains without consequences. However, after months and even years, with the weakening of immunity as a result of any other disease, malnutrition or stress, the TB bacteria begin to multiply, destroying the weight a host cell and assuming the beginning of the development of active tuberculosis.
In some cases, at the first contact with infection in body bacteria can proliferate, causing severe damage to lung tissue. These are cases of active pulmonary tuberculosis, which can become a source of further spread of the infection.
In some cases, pathogenic bacteria, once in the lungs, can through the lymph vessels or bloodstream to be transported to other parts of the body, getting into kidneys, bones and joints, brain, etc. With good protective forces of an organism of the bacilli remain in a dormant state for a long time, but with the weakening of the body in those parts of the body may also develop tuberculosis.
If the Airways get too many tubercle bacilli-mycobacteria, the body can not cope with the onslaught. If You are a long time to communicate with TB, your body undergoes permanent attacks and there may come a time when he will no longer be able effectively to resist infection. Also known other factors contributing to the development of mycobacteria in the body:
- stress - emotional or physical stress;
- excessive consumption of alcohol;
- Smoking;
- inadequate or defective nutrition;
- other diseases that weaken the body.
Children, adolescents, pregnant women and the elderly are more vulnerable to infection.
To avoid getting tuberculosis, it is necessary to lead a healthy lifestyle. For good health needs a healthy nervous system, so it is important to avoid stress. Food must be complete, must contain sufficient amounts of protein. An important condition to support healthy should be a daily normal exercise. Dusty unventilated space conducive to the spread of tuberculosis bacteria. For the prevention of disease to ventilate the premises.
X-ray examination of the chest can be done in the clinic by place of residence. If you suspect TB local doctor or medical specialist after clinical investigation with direct consultation with a TB specialist in TB hospital or subcabinet.
There are several vulnerable groups of citizens and professional groups of specialists who, because of various reasons, must often be tested for tuberculosis.
Twice a year needs to pass inspection:
- the military men passing military service on an appeal;
- workers of maternity hospitals (departments);
- persons who are in close household or occupational contact with sources of tuberculosis infection;
- person removed from the dispensary in a tuberculosis institution or unit in connection with the recovery for the first 3 years after deregistration;
- persons who have had tuberculosis and recovered from it yourself, but having residual changes in the lungs during the first 3 years since the detection of residual changes;
- HIV-infected;
- the faces consisting on the dispensary account in narcological and psychiatric institutions;
- persons released from detention centers and correctional institutions for the first 2 years after release;
- untried contained in pretrial detention and convicts in penal institutions.
Once a year must undergo a mandatory inspection for tuberculosis:
- sick of chronic nonspecific diseases of the respiratory system, gastrointestinal tract, genitourinary system, diabetes;
- persons receiving corticosteroid, cytostatic and radiation therapy;
- individuals belonging to social groups at high risk of TB disease: without a certain residence, migrants, refugees, internally displaced people, living in stationary establishments of social service and institutions of social assistance for persons without fixed residence and occupation;
- employees of institutions for children and adolescents: social service, medical, health resort, educational, Wellness and sports.
In addition, the individual (extraordinary) right around:
- of the person seeking medical care with suspected TB disease;
- persons living together with pregnant women and newborn babies;
- citizens called up for military service or entering the military service under the contract;
- persons for whom the diagnosis "HIV-infection" is set for the first time.
To reduce the risk of TB disease child vaccination BCG, which is mandatory and is free of charge to all children in the hospital with 3 days of life (in the absence of medical contraindications). Children not vaccinated at hospital, vaccinated in the departments of pathology of newborns or in terms of the children's polyclinic in the age of 2 months prior to vaccination with BCG, you must first put the Mantoux test with 2 TE and vaccination is carried out in the case of a negative sample.
Re-vaccination – revaccination of BCG is 7 years and 14 years. If the child or adolescent in decreed age (7 and 14 years) had a medical withdrawal or Mantoux test with 2 Tu was questionable (and it is also a contraindication to vaccination), vaccination against tuberculosis is carried out within one year after the occurrence of a specified age. Revaccination with BCG is not infected with Mycobacterium tuberculosis (MBT) tuberculinization children and adolescents.
If the child or adolescent is not formed postprevious sign (hem) or its size is less than 2 mm, then the negative to the Mantoux test with 2 Tu 2 years after vaccination and 1 year after a booster vaccination is revaccination against tuberculosis.
For the timely detection of tuberculosis infection for all children in Russia annually tuberculin Mantoux test.
Frequently ill children or children with chronic illnesses, are at risk for tuberculosis. This category of children is given special attention, we provide additional treatment and preventive measures determined by the local doctor, medical specialist, medical staff of children's institutions. In the presence of medical indications the child is sent for a consultation with a tuberculosis specialist at the place of residence. In order to protect the child from diseases, adults themselves must be confident that they are HEALTHY, and in a timely manner to undergo a medical examination.
The main symptoms characteristic of tuberculosis:
- cough for 2-3 weeks or more;
- chest pain;
- weight loss;
- the presence of blood in sputum;
- night sweats;
- intermittent fever;
- General malaise and weakness;
- the increase in peripheral lymph nodes.
If You experience these symptoms, immediately contact a doctor!
A sick man is a source of infection until you begin intensive treatment. But once treatment started, the risk of infecting others decreases rapidly. This may confirm the analysis of the sputum for tubercle bacilli. If they are not detected by microscopic examination, then the risk of infection for the family in case of Your illness is small. However, if You started taking TB pills, it is very important to complete the full course of treatment, that is to take all, without exception, prescription drugs without a break, even if You begin to feel better.
Unlike other diseases, the treatment of TB requires therapy with several special antibiotics for a long time. The reason for this is the presence of three different activity groups of the tuberculosis bacteria:
1) Actively proliferating bacteria in open cavities. They come out with the phlegm, making the patient a source of infection to others.
2) Slowly proliferating bacteria in the protective cells of the body surrounding the open cavity.
3) Bacteria in dense foci, which most of the time "asleep", but in the absence of appropriate treatment can be activated and also cause great harm to the body.
So even if You after the start of therapy I felt relief and for a long time You almost nothing bothers, you must complete the full course of treatment to kill even dormant bacteria, otherwise the disease will not be slow to return. It is also very important not to miss pills and not to interrupt the treatment. If treatment is not completed or is interrupted, only kill some bacteria and the remaining will develop resistance to drugs and dress up in the usual impenetrable for drugs armor. The disease will not be cured, or will go into a form that is resistant to drug effects, which is even more dangerous both for You and for people around You.
If You missed the pills as soon as possible inform Your doctor, he will advise you on how to avoid unpleasant consequences.
It is also very important to inform your doctor of any signs of side effects when taking medicines, such as rashes, jaundice, visual disturbances or hearing loss, gastrointestinal disorders, tingling in the tips of the fingers and toes. The doctor will give You necessary advice. To overcome infection is very important to the General health status, so please refrain from alcohol and Smoking (or at least reduce their intake) .
Try to rest more, to eat properly and adequately, breathe the fresh air. Never plebisite on the floor or on the road, use your individual bowl. Ventilate from time to time the room in which you are. Coughing, cover your mouth with a handkerchief.
Be attentive to relatives and friends. If You notice any symptoms of tuberculosis, advise to immediately seek medical attention.
Currently, there are a lot of anti-tuberculosis drugs, use of which allows to cure the disease completely. The main conditions of treatment of tuberculosis is to identify through preventive examinations and early treatment of patients for specialized medical help to the doctor-the phthisiatrician. A TB patient must take the treatment in full, as prescribed by his doctor. Treatment interruptions lead to the development of drug-resistant forms of TB, cure that much more difficult.
The patient must be fully treated for at least 6-8 months: 2-3 months in the tuberculosis hospital, then in a day hospital for tuberculosis office and then as an outpatient. TB drugs are very expensive, but patient they are free. If the patient stops treatment early or does not take all prescribed medications, this leads to the emergence of drug resistance and subsequently Mycobacterium TB drug resistance can be spread to family members and others.
Resistance to one drug is amenable to treatment with other anti-TB drugs. But when resistance occurs to several key anti-TB drugs, this represents a significant risk for the patient and for society.
To treat patients with multiple resistant Bacillus is difficult and extremely expensive (the course of treatment is 100-150 times more expensive than conventional treatment), the treatment duration can be several years and not always it is successful: you can lose not only easy (after surgery), but also life. So the main thing is the observance of patients prescribed deadlines and methods of treatment and all the drugs that are prescribed by the TB doctor.
If the family is sick with tuberculosis, first of all he should realize that his culture and discipline very much depends. Of course, the patient needs to follow the rules of personal hygiene. But equally important is literacy in the hygiene of all family members and friends living in the outbreak of tuberculosis.
The patient must have their room, and if this is not possible, then your angle. The bed should be put closer to the window, to remove her screen. You can't sleep on the couch that day use other family members, where children play. The patient should have his own dishes, all the things should be stored separately. The bowl should handle the patient himself.
How to help a patient, how to disinfect his clothes, do the cleaning in the room, treat phlegm – this will tell in the tuberculosis clinic. The whole family of the patient must be supervised in the clinic by contact, in time to be surveyed and undergo treatment in accordance with the recommendations of the TB.
Do I need to treat the apartment if before there was a TB patient?
Definitely. Mycobacterium tuberculosis for a long time remain viable in the environment, especially in humid and dusty environments. Detrimental to the mycobacteria are long UV rays, and disinfectants. It is better that the treatment facilities have been conducted by specialists of disinfection services. If Your village no desistance, get advice on proper treatment of the room on their own, You can have a TB.
WHAT YOU NEED TO KNOW ABOUT TUBERCULOSIS PEOPLE LIVING WITH HIV?
It is believed that the age of 30 all people in our country and in several other countries are carriers of the causative agent of tuberculosis (Mycobacterium tuberculosis). When immunosuppression in humans aktiviziruyutsya Mycobacterium tuberculosis and develop the disease. The human immunodeficiency virus that kills important cells in the human immune system – the CD4 lymphocytes, thereby weakening the protective properties of the organism. Under the influence of the virus the human immune system, including tuberculosis, slowly weakening. Against the background of a weakened immune system tuberculosis.
Also high risk of development of tuberculosis in a patient with HIV-infection, which is directly in close contact with patients with active TB, for example, in the family of tuberculosis, prison, etc. how Tuberculosis is transmitted by airborne droplets and by inhalation of dust (coughing, sneezing, talking, spitting phlegm on the floor).
If you do not follow the necessary preventive measures, then the patient is HIV-infected may get TB. If tuberculosis is not treated, it can lead to death.
Timely unrecognized and therefore untreated tuberculosis in a patient with HIV-infection quickly involves a process of several organs and systems of the body, and the disease can lead to the adverse outcome.
After the discovery of HIV infection, the patient should be constantly observed by an infectious disease physician at the place of residence (in the office of infectious diseases or the center for prevention and fight against AIDS). It is necessary for regular monitoring of the immune status of the patient HIV infection. If necessary, the patient will be free to obtain expensive drugs for the treatment of HIV infection. In addition, the patient is regularly examined for TB: when registering in infectious diseases and then 1 every 6 months adults and adolescents undergo fluorography or x-ray examination of the chest, do a Mantoux test and receive consultation of the doctor-phthisiatrician (a specialist dealing with the diagnosis, treatment and monitoring of patients and infected with TB).
When identifying a sharp decline in immunity (a CD4 cell count 300 1 ml of blood and below with the analysis on the immune status) infectious disease physician will direct the patient on consultation to the doctor-the phthisiatrician, which, if necessary, prescribe preventive treatment of tuberculosis and will give out free expensive anti-TB drugs during the period of prophylactic treatment (from 3 to 6 months).
If the TB doctor offers to disinfect the room, where the patient HIV-infected patient with active tuberculosis, this proposal should not be discarded. In disinfection of the causative agents of tuberculosis in the room die.
Patient with HIV-infection should abandon bad habits. Smoking, alcohol and drugs dramatically reduce immunity to tuberculosis in any person, not to mention a sick HIV-infection. Joint use of drugs leads to the fact that patients with HIV-infection and TB patients are in contact with each other, which contributes to the rapid spread of TB among HIV-infected patients.
In the case of a patient with HIV-infection changes when fluorography or x-ray examination of chest organs, as well as identifying over-reaction to a Mantoux test or deterioration of the results compared with the results of previous tests, the patient is immediately sent an infectious diseases doctor for a consultation with a TB specialist for exclusion of tuberculosis.
The appearance of the patient with HIV-infection symptoms such as weakness, sweating, poor appetite, weight loss, rise in body temperature to 37-40° C and above, is grounds for immediate treatment to the doctor to exclude tuberculosis.
In 95% of cases TB affects the respiratory system. In such cases, in the first place on the background of the above symptoms are the complaints of cough: dry or with phlegm, shortness of breath during normal physical exertion, chest pain, and sometimes hemoptysis. It should be noted that at low immune status in tuberculosis of respiratory organs cough may not be. Patient worried constantly high body temperature, not extending the treatment with broad-spectrum antibiotics and briefly falling when taking antipyretics.
Against the background of such well-being should pay attention to headache, back pain, bones, joints, impaired urination, swollen lymph nodes in the neck and axillary region, especially repeated increase and the appearance of fistulas. All these symptoms should be cause for immediate treatment to the doctor.
When sputum doctor gives a patient referral for sputum smear for Mycobacterium tuberculosis. When the patient's symptoms giving grounds to suspect extrapulmonary localization of tuberculosis, the doctor may prescribe a urine test, the discharge of fistulas, the tissue of enlarged lymph nodes taken for the study in the hospital, the causative agent of tuberculosis. Also conducted other tests for diagnosis of tuberculosis with extrapulmonary localization: x-ray (including computed tomography), ultrasound of internal organs, etc.
Timely treatment tuberculosis – the key to cure it!
If a patient with HIV-infection diagnosed with active tuberculosis, then further treatment and surveillance of these patients is carried out jointly by doctors TB doctors and infectious disease specialists.
Tuberculosis in patients with HIV-infection is curable! Currently developed sufficiently effective and accessible therapy for this disease. Most patients with HIV infection there is a good effect in the treatment of tuberculosis. However, the treatment of tuberculosis patient with HIV-infection should be treated seriously, as in violation of the chemotherapy of this disease possible emergence of resistant to anti-TB drugs forms of the pathogen. Chemotherapy of drug-resistant forms of TB is challenging and may not lead to good results. Resistant to anti-TB drugs of Mycobacterium tuberculosis pose a serious risk of the spread of tuberculosis among large groups of people, especially for HIV-infected patients.
It should be remembered that TB drugs should be taken for patients with HIV and TB are strictly under the control of medical personnel at all stages of treatment of tuberculosis.
Tuberculosis in HIV-infected patients treated from 10 to 18 months continuously. Then, being on the dispensary account in a TB, the patient will undergo regular check-UPS and preventive treatment courses to prevent relapse of tuberculosis. In the process of TB treatment the patient regularly (1 time per 1-3 months) needs to consult with an infectious disease doctor.
A healthy lifestyle is the basis of prevention of many diseases, including tuberculosis in HIV infection.
Healthy eating helps a person feel good. In HIV infection it is very important to control the quality of the food. The presence of HIV infection means a weakened immune system, including tuberculosis. Malnutrition can cause tuberculosis in a patient with HIV-infection. The principles of diet, is conducive to the prevention of tuberculosis in HIV infection, is simple: more calories, more protein, eat more often (5-6 times a day), but gradually.
Proper sleep and rest is necessary to maintain immunity and restore good emotional mood of the person. Vacation can be quite varied: passive (reading, watching TV, movies) and active (excursions, Hiking, travel).
Source: http://tbpolicy.ru/topics/?id=26