Tuberculosis is a bacterial infection of the lungs that can also affect other organs such as the brain, spine, or kidneys, according to the Centers for Disease Control and Prevention (CDC).
Tuberculosis is relatively rare in the U.S., with the CDC reporting that just under 8,000 Americans had active infections in 2021. In contrast, worldwide infection rates are much higher, according to the World Health Organization (WHO).
Recent data show that more than 10 million people, including 1.1 million children, became infected in 2020. At any given time, roughly a quarter of the world’s population has tuberculosis. Eight countries account for two-thirds of all cases: India, China, Indonesia, the Philippines, Pakistan, Nigeria, Bangladesh, and South Africa.
While many people with tuberculosis experience no symptoms, it causes serious health problems for others. As of recent years, tuberculosis is second only to COVID-19 on the list of deadliest infections worldwide (via WHO).
What causes tuberculosis?
A bacterium called Mycobacterium tuberculosis (M. tuberculosis) causes tuberculosis, according to the WHO. When people with an active tuberculosis infection in their lungs cough, sneeze, or spit, tiny droplets containing this bacterium spread into the air. People who inhale these droplets may become infected with tuberculosis, but not everyone who is exposed develops the disease. Tuberculosis usually spreads between close contacts, such as people sharing a household, rather than casual contacts like passersby at a bus stop or grocery store (per the American Lung Association).
Once inhaled, the droplets containing M. tuberculosis enter the lungs, where the bacteria become lodged in the lung tissue. In healthy people, their strong immune systems can typically prevent tuberculosis cells from growing. But people with weak or compromised immune systems will have trouble battling the infection. The cells quickly grow in the lungs, then move through the bloodstream and lymphatic system to other parts of the body including the bones, brain, spine, skin, kidneys, and lymph nodes. The tuberculosis cells will divide and grow in these areas as well, damaging healthy tissue and causing the symptoms of tuberculosis.
Symptoms of active tuberculosis
People who develop an active tuberculosis infection will feel sick, with some specific symptoms relating to the part of the body where the bacteria are growing. According to the Mayo Clinic, some symptoms of tuberculosis include fever, chills, fatigue, and night sweats. People with tuberculosis may also experience a loss of appetite and unexplained weight loss. Because many viral and bacterial infections cause similar symptoms, these symptoms do not necessarily indicate a tuberculosis infection.
Other symptoms show that tuberculosis is present and growing in the lungs. Tuberculosis patients may start coughing up blood, have a lingering cough that lasts for three weeks or more, and feel chest pain or pain when breathing or coughing. If the infection has spread to other parts of the body, such as the bones, patients may feel pain or other symptoms in the infected organs. For instance, bloody urine can indicate a tuberculosis infection in your kidneys.
Some strains of tuberculosis are resistant to drugs
Over time, some strains of tuberculosis have become resistant to treatment, which means that some M. tuberculosis cells are not affected by antibiotics that normally kill tuberculosis germs. Drug-resistant tuberculosis can develop when people start treatment, then stop taking their medication before completing the prescribed course, which is why it is so important to finish antibiotics. According to Healthline, there are now tuberculosis strains resistant to first-line drugs such as isoniazid and rifampin, and others are resistant to both first- and second-line treatments. These strains are becoming a greater health problem worldwide.
Drug-resistant strains of tuberculosis are more difficult to treat, especially if the strain is resistant to more than one drug or if the patient has a weak or compromised immune system. When treating drug-resistant tuberculosis, doctors may have to rely on medications that cause more serious side effects. They may also have to prescribe treatments that last much longer than the standard four to nine months. Patients should finish their prescribed course of treatment to prevent the development of drug-resistant tuberculosis.
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