World TB Day 2021: Tuberculosis kills more number of people in India every year than the lives COVID19 has claimed over the past 12 months? Today, all we need is a surge in our actions to reduce the TB burden, tells Dr Anshu Punjabi.  

New Delhi, March 24, 2021: In the past year, the COVID19 virus grabbed much of our attention. The collateral damage that it caused in one year is very unimaginable. But did you know, Tuberculosis (TB) kills a more significant number of people in India every year than the lives COVID19 has claimed over the past 12months?

Tuberculosis continues to inflict a large quantum of socioeconomic cost on our nation. Although TB has been curable and our government has made great strides to improve diagnosis and drug delivery mechanisms, our war with this deadly disease exists. All we need today is a surge in our actions to reduce the TB burden intensely. But how is that possible?

Well, the best approach to this is to sensitize people with the growing burden of TB and empower them enough to identify symptoms, report it early, undergo timely diagnosis, and complete adherence to treatment. So, first things first.

WHAT IS TUBERCULOSIS AND HOW DOES IT AFFECT US? TB is an infection caused by bacteria called Mycobacterium Tuberculosis and spreads through the air from one person to another when an infected person coughs, sneezes or laughs. Even though the bacteria travel easily, it’s not easy to be infected by TB. Most often, it’s spread between family members, close friends, and people who live or work together. TB most commonly affects the lungs, but it can affect other parts of the body as well, like lymph glands, abdomen, spine, joints, etc.

There are two kinds of tuberculosis (TB) infections — latent TB and active TB disease.

WHAT IS LATENT TB? In most healthy people, the body’s natural immune system kills the bacteria and there are no symptoms. Sometimes, the immune system cannot kill the bacteria but manages to prevent it from spreading in the body. You will not have any symptoms, but the bacteria will remain in your body – this is known as Latent TB. People with Latent TB are not infectious to others, and do not feel ill. It is usually happens to children. Sometimes, this dormant TB gets activated when the body’s immune system is extremely low, say in the case of HIV, cancer, diabetes, etc.

This may occur like a normal fever and can go unnoticed. In India, we do not treat latent TB, as most people would have been exposed to the bacteria at some point in time. Moreover, there is no good evidence that all these people will develop active TB disease in the future, or that treating Latent TB will prevent further reinfection.

WHAT IS AN ACTIVE TB? When the immune system is unable to kill or contain the bacteria, Active TB develops. The lungs’ Active TB disease is contagious, which means it can be spread from one person to another. It is most often spread through the air; these bacteria may enter the air when a person with TB disease of the Lungs or throat coughs. People nearby may breathe in these bacteria and get infected. People get sick from the TB bacteria that are alive and active. 

SO, WHAT ARE THE RISK FACTORS?

• Being in close contact with a person with Active Lung TB disease is highly risky
• If you are in contact with any groups known for passing on TB, such as the homeless, injection drug users, and persons with HIV/AIDS
• If you are living or working with people who are at high risk for TB, such as those in hospitals, homeless shelters, prisons, slums, or refugee camps 

MAJOR SIGNS AND SYMPTOMS THAT YOU SHOULDN’T IGNORE:

• A cough that lasts two-three weeks or more
• Pain in the chest, with cough or at rest     
• Coughing up blood or thick mucous
• Night sweats
• Feeling weak or tired
• Weight loss
• Not wanting to eat
• Fever, mainly in the evening
• Swollen neck lymph-gland(s)

The longer people wait, the TB disease worsens. Although the stigma associated with TB has gone down significantly, people need to be alert, aware, and responsible when it comes to identifying symptoms and getting treated early. TB is treatable and curable. Treatment for drug-sensitive TB is a combination of antibiotics for six months. People with drug-resistant TB will need more extended treatment with at least 5-6 drugs under expert supervision.

(Dr Anshu Punjabi is Consultant-Pulmonologist & Sleep Medicine Expert, Fortis Hospital, Mulund; Image by Wilfried Pohnke from Pixabay)