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Facts about tuberculosis

Most people have heard about tuberculosis, and many believe that the disease is extinct. But tuberculosis is actually the infectious disease taking the most lives globally; 1,6 million people died from the disease in 2017. But what is tuberculosis?

Definition

Tuberculosis is an infectious disease. It is most often situated in the lungs, but can present in all organs. The bacteria spread through small aerosols in the air.

Cause

Tuberculosis is caused by the bacteria Mycobacterium tuberculosis.

The mycobacteria can enter into the air from someone who has active tuberculosis in the lungs, and who is coughing. The small aerosols can also enter into the air when talking, laughing og singing. If another person breathes in the aerosols, he/she can become infected.

Tuberculosis is much less infectious than diseases such as influenza or measles.

Not all tuberculosis is infectious

Tuberculosis in the lungs, and a rare form of tuberculosis in the throat, are the only types of infectious tuberculosis. Tuberculosis in other organs, such as kidneys  or lymph nodes, are not infectious. However, you still need treatment in order to get cured.

If you have been diagnosed with infectious tuberculosis in the lungs, the health care system will map who you have been in contact with. This is in order to check if others have been infected.

People with latent tuberculosis cannot infect others.

Tuberculosis can not infect others when you:

  • drink from the same cup as someone with tuberculosis
  • eat from the same plate
  • eat with the same cutlery
  • hugs someone with tuberculosis

Latent tuberculosis

It is possible to get infected with tuberculosis without getting sick. If you have the mycobacteria in your body, but not sick, it is called latent tuberculosis. Latent tuberculosis is not infectious. It is estimated that  1/3 of the worlds population have latent tuberculosis, but only 5-10% will develop the disease.

The risk of developing the disease is higher if you have a weak immune system due to poor nutrition, stress, other diseases like hiv or diabetes, or if you are using certain medications that lowers your immunity.

Latent tuberculosis can be treated with preventive treatment.

Vaccine against tuberculosis

Unfortunately the  BCG vaccine is not fully effective. The  BCG vaccine prevents severe forms of tuberculosis for children, but it gives less protection for adults. Starting 2009, the BCG vaccine in Norway  is only given to children with a high risk of tuberculosis.

Symptoms

Typical symptoms for tuberculosis is:

  • cough for two-three weeks or more
  • cough with a lot of mucus, sometimes blood
  • chest pain
  • poor appetite
  • weight loss
  • fatigue
  • night sweat
  • prolonged fever

There is no cough when having tuberculosis that is not situated in the lungs, however all the other symptoms listed can present. In addition, there might be symptoms from the affected part of the body.

For example, if you have tuberculosis in the lymph nodes, you can experience swelling of the neck, under the arms or in the groin. If you have tuberculosis in the skeleton, you may for example have back pain.

The symptoms of tuberculosis may be similar to symptoms for many other diseases. Please visit your doctor to find out if you have tuberculosis.

Tests

To check if you have been infected with TB, you can take a skin test, Mantoux, or a blood test, often called IGRA test.

Neither Mantoux or IGRA can distinguish between latent or active infection- meaning if you only are infected , or if you are also sick. To find out if you are sick, you have to take additional tests.

Tuberculosis in the lungs are diagnosed by a sputum test and chest x-ray

Mandatory TB screening for immigrants

Immigrants from countries with a high burden of  tuberculosis will be screened for tuberculosis when moving to Norway. The intention is to exclude or identify active tuberculosis in the lungs in order to provide early treatment to avoid advanced disease and transmission.

Treatment

Tuberculosis is treated with antibiotics, usually in tablet form. This is provided for free in Norway. The treatment is for a minimum of 6 months, but sometimes longer.

You must continue treatment even if you don't feel sick anymore

The treatment of tuberculosis is today quite good and effective. After two to four weeks of treatment, you are no longer infectious. However, to ensure that all the bacteria are killed, you have to complete the full 6 months of treatment.

In Norway, we have what is called Directly Observed Treatment (DOT). This means that a health care worker observes the patient when swallowing the medication. Usually, the health care worker will visit you at home on a daily basis.

Even if you are feeling better and healthy, it is crucial that you complete the full treatment period. If not, some bacteria might survive and you can become sick again.

Sometimes the bacteria are resistant and the normal treatment will not work. In those instances, the treatment provided will be longer and tougher.

Prognosis

When taking treatment for tuberculosis in Norway, you will be cured.  

Normally, you will be called for check-ups for up to two years after you completed treatment.