How to catch tuberculosis

Tuberculosis - also a topical issue in this country

The illness

Tuberculosis (TB or Tbc for short) is a contagious disease caused by bacteria.

The bacteria mainly attack the lungs. An affected person gives off germ-containing droplets when they talk, sneeze or cough, which others can breathe in with the air. But not everyone who comes into contact with the bacteria will get sick. The body's defenses fight the pathogens and often render them harmless. Sometimes the bacteria remain dormant in the body for years. If the immune system is weakened, the bacteria can spread in the body, including in lymph nodes, bones, urinary tract or meninges.

Who gets sick?

The disease breaks out in around one in ten and needs treatment. This mainly affects close contact persons of patients with contagious pulmonary tuberculosis and people with weakened immune systems, these are above all:

  • People with HIV or AIDS

  • Infants, young children and the elderly

  • People who take drugs that suppress the immune system on a long-term basis

  • People who are addicted to drugs or alcohol

  • Prison inmates

Signs and complaints

Tuberculosis can break out without people noticing. It often begins insidiously, the symptoms are often ambiguous:

  • Cough or cough, with or without sputum
  • unwanted weight loss
  • fatigue
  • light fever
  • Night sweats

The complaints last for weeks. If left untreated, they usually worsen. In the past, the disease was also known as "consumption".

Investigations

If the cough persists, doctors recommend taking an x-ray of the lungs to clarify the cause of the cough. If tuberculosis is suspected, the diagnosis is confirmed by detecting the bacteria, for example in the sputum.

Reporting requirement

Doctors are legally obliged to report tuberculosis in need of treatment to the health department. In the case of contagious tuberculosis, this initiates examinations of close contacts of the sick person. This is called Environmental investigation.

People who have become infected can receive preventive treatment early on. An outbreak of the disease and its further spread are to be prevented.

Treatments

Tuberculosis can usually be treated well. Without treatment, about 7 out of 10 sufferers die; in the case of resistance (see below), however, the prospect of a cure is significantly worse.

The usual treatment lasts 6 months. Sufferers are given drugs that kill the bacteria, so-called Antibiotics: four active substances in the first 2 months, two in the following 4 months. These are taken at the same time every day.

Experts recommend offering advice and an HIV test to anyone with tuberculosis. If the test is positive, the HIV disease will also be treated.

Treatment problem: resistances

One problem is that the bacteria are becoming increasingly insensitive - resistant - to the most important drugs. Resistance like this arises mainly because the drugs are not used properly.

The so-called multi-resistant tuberculosis is harder to treat and often contagious for longer. Treatment lasts at least 20 months and should only be done in an experienced center.

What you can do yourself

General information:

  • You can protect yourself against infection by keeping a certain distance from people who are coughing. Also, follow general rules of hygiene, such as washing your hands regularly.

  • If you have a persistent cough and the cause is unknown, see a doctor.
  • A vaccination against tuberculosis is no longer recommended in Germany.

If you have tuberculosis:

  • At first, you are still contagious despite taking medication. You will therefore be isolated at home or in a clinic. It is important that you wear a face mask to limit the spread of bacteria. Only when you are no longer contagious can you go back to your everyday life.

  • Take your medication as directed by your doctor - even if you are feeling much better. Otherwise it can relapse. This not only means a longer illness, but also makes further treatment more difficult.

  • The antibiotics may be better tolerated if you take them after a light meal.

  • Smoking is particularly harmful in the case of pulmonary tuberculosis. If possible, stop smoking.

  • Have your check-ups during and after treatment. Side effects of the drugs or an ineffective treatment as well as a relapse can be detected early. A medication may then be exchanged.

September 2018, published by the German Medical Association and the National Association of Statutory Health Insurance Physicians