| We have tried to gather together the most commonly asked questions below. If you do not find an answer to yours please do not hesitate to email us and we will try to help.
What is Tuberculosis?
Tuberculosis (TB) is a disease caused by a bacterium. It usually affects the lungs but can develop in any part of the body.
I thought TB had been eradicated
Many people today can still remember friends and family struck by TB in this country up until the 1950s. But with the advent of antibiotics it was thought TB would be consigned to the history books – a disease of the past. But TB never did disappear, and it never will until it is controlled worldwide. Even in Britain and Ireland, the number of cases did not go below 5,000 a year, and has risen since 1987 to over 8000 a year (compared to just over 5,000 new HIV diagnoses last year). Over 400 people a year die of TB in the UK, approximately the same number as those who die of AIDS related diseases. Twenty years ago asthma was Britain's most rapidly increasing respiratory disease. Today TB clearly holds that place. Yet TB is curable.
Why was TB not eradicated if we have had the cure for 50 years? What went wrong?
Complacency. The public and the medical profession’s belief that TB has been eradicated has led to cases of TB being missed or misdiagnosed – with serious consequences for the individual, and the people they pass the disease on to. One man didn’t go to the doctor despite having a cough for over two years – he thought as a smoker he would just be told off and told to give up. He died when the TB causing the cough spread to his brain. Janeanne from East Anglia was told she was being a “silly girl” and a hypochondriac when she kept going to the doctor with chest complaints. She passed on TB to members of her family including her nephew Travis, and lost part of a lung because her diagnosis was delayed.
Poverty. Although anyone can catch TB, poverty means people are much more likely to be susceptible to the disease. And poverty is NOT just an overseas problem.
Globalisation. International travel has grown significantly since the 1970’s when experts believed TB would soon be unknown in Britain and Ireland. Claire, a healthy young woman from a small seaside town in East Sussex caught TB whilst backpacking in India.
What are the Symptoms of Tuberculosis?
The most common symptoms of TB are:
A cough that lasts more than three weeks
Loss of weight for no obvious reason
Fever and heavy night sweats
A general and unusual sense of tiredness and being unwell
Not wanting to eat
in the later stages
coughing up blood
How is TB diagnosed?
Tuberculosis of the lung usually causes characteristic changes on a Chest X-ray which will suggest but not confirm the disease. Once a chest x-ray has been taken which may suggest that tuberculosis is present, the diagnosis should be confirmed by obtaining phlegm for bacteriological analysis. Only if the tuberculosis bacterium is found in the sputum of a patient is tuberculosis disease proved. Because the bacterium can be particularly difficult to grow this process may take some weeks.
Can TB be cured?
Yes, in almost every case, but only if the full course of treatment is taken as prescribed, or else the disease can return in a drug-resistant form.
How is TB Spread?
Tuberculosis is an airborne disease. Only people with TB in the lungs (called Pulmonary TB) can spread the disease. They can cough up the bacteria and another person can breathe it in. A bit like a cold is caught, but not as easily. To get TB, you usually need to have very close, daily contact with someone who has the disease. Most people get it from a family member, friend, partner, or co-worker. You're not likely to get TB from someone coughing on the bus or at a restaurant. It is not spread by dishes, drinking glasses, sheets or mattresses.
TB can also be caught by drinking milk from cows with Bovine TB, which is one of the reasons why milk in developed countries is pasteurised to kill the bacteria.
How is TB treated?
Once tuberculosis is suspected treatment should be started. The treatment regimen recommended by the World Health Organisation includes at least three and preferably four specific antibiotics. They are called isoniazid, rifampicin, pyrazinamide and ethambutol. For convenience they may be given in a combination tablet which combines the antibiotics in a single tablet. Treatment must continue for at least six months though the number of antibiotics can be reduced once the bacterium’s sensitivity has been found by the laboratory. There has been a recent increase of drug-resistant tuberculosis both in the UK and world wide. It is of concern that a disease which still represents the commonest cause of death from a single infectious agent is becoming resistant to treatment. The main cause of resistant disease is patients failing to take their treatment as prescribed.
Can the TB treatment cause side effects?
Rifampicin will turn urine and other body secretions such as tears orangy-red. It also interacts with other medicines, in particular it reduces the effectiveness of the contraceptive pill. It is therefore important to warn your doctor when prescribing other medicines that you are on TB treatment.
The tablets may rarely cause some of these:
- Rash
- Giddiness
- Sickness
- Pins and Needles
- Jaundice
If any of these occur, patients should contact their TB nurse or doctor
Do patients with TB have to go into hospitals or Sanatoria or do they have to stay off work while they are being treated?
No, although they may be admitted into hospital very briefly to confirm the diagnosis. Patients taking treatment very quickly become non-infectious and therefore can go about their daily business as usual and do not have to be isolated in sanatoria as used to happen before a cure was developed.
Can TB Re-occur?
Yes it is possible. Like any bacterial infection, it can be caught and cured more than once. So if you have any doubts, please consult your local doctor.
Can TB be prevented?
There is a vaccine against TB called BCG but it does not prevent TB in all cases. In the UK it is planned to give it only to babies at special risk of TB.
Is it worth having BCG in adult age or when travelling?
If you are planning to visit/stay for more than one month in a country with a high prevalence of TB, and you have not had a BCG, you are advised to get a skin test to see if BCG is needed. You should visit your doctor in the first instance, and you may be advised to visit a travel health clinic.
How Common is TB?
TB is VERY common in the poorest countries of the world where people often cannot afford effective treatment. That is why TB kills 2 – 3 million people every year – even though it can be cured. Even in Britain, where most people thought it had been wiped out, there has been an overall increase of 20% in the last decade, with an increase of 80% in London. The figures are still rising.
The newspapers seem to imply that TB in the UK is all due to immigrants and refugees – is this correct?
No. About half of all TB in Britain occurs in British people born in the UK. Although anyone can get TB, a person’s natural immunity to disease suffers from living stressful lifestyles, in poor conditions or on poor diets, so immigrants or refugees in those situations are more vulnerable to the disease. Also living in overcrowded housing makes the spread of TB more likely. The average time between arriving in the UK and getting TB is around 5 years.
Why are poor people, homeless people, immigrants and refugees statistically more vulnerable to TB?
Because a person’s natural immunity to disease suffers because of poor nutrition and stressful lifestyles. Also living in overcrowded housing makes the spread of TB more likely.
Is it right that only poor people get TB?
No, anyone can catch TB, even cabinet ministers (Labour Party Chair Ian McCartney for instance). But if you are poor, the risks are greater.
Is it true that you cannot reduce TB unless you reduce poverty?
No. TB can be cured, and prevalence greatly reduced even in the poorest communities, using well established drug treatment, and it is one of the cheapest diseases to cure.
Isn’t TB Alert just scare-mongering? Surely TB isn’t that much of a problem?
TB has been declared a Global Emergency by the World Health Organisation, and is one of the world’s three greatest infectious diseases (along with HIV and Malaria)
Is it true that most TB in the world is now due to HIV/AIDS?
No. Most people with TB in the world are not infected with HIV. However because HIV affects the immune system it makes people more likely to catch TB, and HIV is an important cause of the increase of TB in sub Saharan Africa where HIV is spread mainly by heterosexuals.
Why does TB Alert have programmes to cure people with HIV/AIDS of TB? Surely there is no point if they are going to die anyway?
Curing any patient of TB prevents them spreading TB in the community, and is always worthwhile (one person with TB untreated can spread the disease to 10-15 others in a year). Also, a patient with TB and HIV/AIDS lives longer if the TB is cured - perhaps long enough to get the HIV drugs which will enable them to live for decades longer.
Why does TB Alert work overseas – surely it is more cost effective to sort out the UK problem first?
TB Alert is active in poor countries like India because TB cannot be controlled in one country (eg the UK) unless it is controlled worldwide. With holiday and business destinations including more and more developing countries, and plane travel so easy, it is impossible to prevent TB from entering one country. It is an airborne disease - if you can breathe you can catch TB – we all need to be aware of it! Even if we stopped all travel into this country – whether through immigration or by preventing UK citizens traveling to poor countries, we still could not prevent it – many people in this country were infected with TB when it was much more rife here (or have been infected abroad in the past) – and although they are healthy now (and not infectious), if their immune system were to break down – due to stress, old age or other diseases, the TB could become active – making them ill and able to pass it on.
How can I help TB Alert fight Tuberculosis around the world?
Please make a donation or see how you can get involved.
I have another question that is not listed – what do I do?
Please send us an email (click here for email), and we will endeavour to get back to you as soon as possible. However please be aware that you may not receive a reply the same day. If several people ask the same question we will add it to the Frequently Asked Questions list.
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