How does tuberculosis affect your body. What are the main symptoms of TB. Can tuberculosis spread easily from person to person. How is TB diagnosed and treated effectively. Is there a vaccine available for tuberculosis. What’s the difference between latent TB infection and active TB disease.

What is Tuberculosis and How Does It Affect the Body?

Tuberculosis, commonly known as TB, is a potentially serious infectious disease caused by bacteria that primarily affects the lungs. However, it can also impact other parts of the body, including the brain, kidneys, and spine. Understanding how TB affects the body is crucial for early detection and proper treatment.

TB is caused by Mycobacterium tuberculosis bacteria that spread through the air when an infected person coughs, sneezes, speaks, or sings. These bacteria can remain airborne for several hours, depending on the environment, making it possible for others to inhale them and become infected.

How TB Impacts Different Body Systems

• Respiratory System: Primary site of infection, causing lung damage and breathing difficulties
• Immune System: Triggers immune response, leading to inflammation and formation of granulomas
• Nervous System: Can cause tuberculous meningitis if it spreads to the brain
• Skeletal System: May result in bone and joint infections, particularly in the spine (Pott’s disease)
• Urinary System: Can affect kidneys and urinary tract, potentially leading to renal failure

Does TB always affect the lungs? While pulmonary TB is the most common form, extrapulmonary TB can occur in various parts of the body. Approximately 15-20% of TB cases involve organs other than the lungs.

Recognizing the Symptoms of Tuberculosis

Identifying TB symptoms early is crucial for prompt treatment and preventing its spread. The signs and symptoms of TB can vary depending on which part of the body is affected.

Common Symptoms of Pulmonary TB

• Persistent cough lasting more than three weeks
• Coughing up blood or sputum
• Chest pain
• Difficulty breathing or shortness of breath
• Fever and night sweats
• Unexplained weight loss
• Fatigue and weakness
• Loss of appetite

Can TB symptoms be mistaken for other conditions? Yes, many TB symptoms are nonspecific and can be confused with other respiratory illnesses or chronic conditions. This is why proper diagnostic tests are essential for accurate diagnosis.

The Transmission and Spread of Tuberculosis

Understanding how TB spreads is crucial for preventing its transmission and protecting public health. TB is an airborne disease, meaning it primarily spreads through the air when an infected person expels bacteria into the environment.

Factors Influencing TB Transmission

1. Proximity to an infected individual
2. Duration of exposure
3. Ventilation in shared spaces
4. Infectiousness of the TB patient
5. Immune status of exposed individuals

Is TB highly contagious? While TB is contagious, it’s not as easily transmitted as some other respiratory infections. Prolonged, close contact with an infected person is typically required for transmission to occur.

Latent TB Infection vs. Active TB Disease: Understanding the Difference

There are two TB-related conditions: latent TB infection (LTBI) and active TB disease. Understanding the difference between these two states is crucial for proper management and treatment.

Latent TB Infection (LTBI)

• TB bacteria are present in the body but inactive
• No symptoms are present
• Not contagious to others
• Can progress to active TB disease if left untreated
• Preventive treatment may be recommended

Active TB Disease

• TB bacteria are actively multiplying in the body
• Symptoms are present and vary depending on the affected area
• Can be contagious, especially if it affects the lungs or throat
• Requires immediate treatment with a combination of antibiotics
• Can be life-threatening if left untreated

Can latent TB infection always progress to active TB disease? Not necessarily. Only about 5-10% of people with latent TB infection will develop active TB disease in their lifetime if left untreated. However, certain factors, such as a weakened immune system, can increase this risk.

Diagnosing Tuberculosis: Tests and Procedures

Accurate diagnosis of TB is crucial for effective treatment and preventing its spread. Several tests and procedures are used to diagnose both latent TB infection and active TB disease.

Common Diagnostic Tests for TB

1. Tuberculin Skin Test (TST or Mantoux test)
2. Interferon-Gamma Release Assays (IGRAs)
3. Chest X-ray
4. Sputum microscopy and culture
5. Molecular tests (e.g., GeneXpert MTB/RIF)
6. Computed Tomography (CT) scan
7. Biopsy of affected tissues

How accurate are TB diagnostic tests? While no single test is 100% accurate, combining multiple diagnostic methods significantly improves the accuracy of TB diagnosis. The choice of tests depends on factors such as the suspected type of TB and the patient’s overall health status.

Treatment Approaches for Tuberculosis

Effective treatment of TB is essential to cure the disease, prevent its spread, and reduce the risk of drug resistance. Treatment approaches differ for latent TB infection and active TB disease.

Treatment for Latent TB Infection

• Isoniazid (INH) for 6 to 9 months
• Rifampin (RIF) for 4 months
• INH and Rifapentine for 3 months (once-weekly dosing)

Treatment for Active TB Disease

• Combination of multiple antibiotics for 6 to 12 months
• Common first-line drugs: Isoniazid, Rifampin, Ethambutol, Pyrazinamide
• Directly Observed Therapy (DOT) to ensure adherence
• Regular monitoring for side effects and treatment response

Why is TB treatment so lengthy? The extended treatment duration is necessary to completely eradicate all TB bacteria from the body, including those that may be dormant or slow-growing. This approach helps prevent relapse and the development of drug-resistant TB strains.

Prevention Strategies and Vaccination for Tuberculosis

Preventing TB infection and its spread is a crucial aspect of public health efforts worldwide. Various strategies are employed to reduce TB transmission and protect high-risk populations.

Key Prevention Measures

1. Early diagnosis and treatment of active TB cases
2. Contact tracing and screening of exposed individuals
3. Treatment of latent TB infection in high-risk groups
4. Improved ventilation in high-risk settings
5. Use of personal protective equipment in healthcare settings
6. Public health education and awareness campaigns

BCG Vaccination

The Bacille Calmette-Guérin (BCG) vaccine is used in many countries to prevent severe forms of TB, particularly in children. However, its efficacy in preventing pulmonary TB in adults is limited and variable.

Is the BCG vaccine recommended in all countries? No, the use of BCG vaccination varies by country. In the United States, for example, it is not generally recommended due to the low risk of TB infection in the general population and the vaccine’s potential to interfere with TB skin test results.

Living with Tuberculosis: Management and Long-term Implications

Managing TB extends beyond the initial treatment phase. Patients and healthcare providers must be aware of the long-term implications and follow-up care required for those affected by TB.

Post-Treatment Care and Monitoring

• Regular follow-up appointments to ensure complete recovery
• Chest X-rays to monitor lung healing
• Sputum tests to confirm the absence of TB bacteria
• Addressing any residual symptoms or complications
• Psychological support for patients dealing with the impact of TB

Long-term Health Considerations

Even after successful treatment, some individuals may experience long-term effects of TB, such as:

• Reduced lung function or scarring
• Increased susceptibility to respiratory infections
• Potential reactivation of TB in cases of immunosuppression
• Social and economic challenges due to prolonged illness

Can TB recur after successful treatment? While rare, TB can recur either due to relapse (reactivation of the original infection) or reinfection. This risk is higher in individuals with compromised immune systems or those living in areas with high TB prevalence.

Understanding tuberculosis, its impact on the body, and the importance of proper diagnosis and treatment is crucial for both individuals and public health. By recognizing symptoms early, adhering to treatment regimens, and implementing effective prevention strategies, we can work towards reducing the global burden of this ancient yet persistent disease. As research continues and new diagnostic tools and treatments emerge, the fight against TB progresses, offering hope for improved outcomes and potentially, one day, its elimination as a public health threat.

Fact Sheets | General | Tuberculosis: General Information | TB

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Tuberculosis: General Information

What is TB?

Tuberculosis (TB) is a disease caused by germs that are spread from person to person through the air. TB usually affects the lungs, but it can also affect other parts of the body, such as the brain, the kidneys, or the spine. A person with TB can die if they do not get treatment.

What Are the Symptoms of TB?

The general symptoms of TB disease include feelings of sickness or weakness, weight loss, fever, and night sweats. The symptoms of TB disease of the lungs also include coughing, chest pain, and the coughing up of blood. Symptoms of TB disease in other parts of the body depend on the area affected.

How is TB Spread?

TB germs are put into the air when a person with TB disease of the lungs or throat coughs, sneezes, speaks, or sings. These germs can stay in the air for several hours, depending on the environment. Persons who breathe in the air containing these TB germs can become infected; this is called latent TB infection.

What is the Difference Between Latent TB Infection and TB Disease?

People with latent TB infection have TB germs in their bodies, but they are not sick because the germs are not active. These people do not have symptoms of TB disease, and they cannot spread the germs to others. However, they may develop TB disease in the future. They are often prescribed treatment to prevent them from developing TB disease.

People with TB disease are sick from TB germs that are active, meaning that they are multiplying and destroying tissue in their body. They usually have symptoms of TB disease. People with TB disease of the lungs or throat are capable of spreading germs to others. They are prescribed drugs that can treat TB disease.

What Should I Do If I Have Spent Time with Someone with Latent TB Infection?

A person with latent TB infection cannot spread germs to other people. You do not need to be tested if you have spent time with someone with latent TB infection. However, if you have spent time with someone with TB disease or someone with symptoms of TB, you should be tested.

What Should I Do if I Have Been Exposed to Someone with TB Disease?

People with TB disease are most likely to spread the germs to people they spend time with every day, such as family members or coworkers. If you have been around someone who has TB disease, you should go to your doctor or your local health department for tests.

How Do You Get Tested for TB?

There are two tests that can be used to help detect TB infection: a skin test or TB blood test. The Mantoux tuberculin skin test is performed by injecting a small amount of fluid (called tuberculin) into the skin in the lower part of the arm. A person given the tuberculin skin test must return within 48 to 72 hours to have a trained health care worker look for a reaction on the arm. The TB blood tests measure how the patient’s immune system reacts to the germs that cause TB.

What Does a Positive Test for TB Infection Mean?

A positive test for TB infection only tells that a person has been infected with TB germs. It does not tell whether or not the person has progressed to TB disease. Other tests, such as a chest x-ray and a sample of sputum, are needed to see whether the person has TB disease.

What is Bacille Calmette–Guèrin (BCG)?

BCG is a vaccine for TB disease. BCG is used in many countries, but it is not generally recommended in the United States. BCG vaccination does not completely prevent people from getting TB. It may also cause a false positive tuberculin skin test. However, persons who have been vaccinated with BCG can be given a tuberculin skin test or TB blood test.

Why is Latent TB Infection Treated?

If you have latent TB infection but not TB disease, your doctor may want you to take a drug to kill the TB germs and prevent you from developing TB disease. The decision about taking treatment for latent infection will be based on your chances of developing TB disease. Some people are more likely than others to develop TB disease once they have TB infection. This includes people with HIV infection, people who were recently exposed to someone with TB disease, and people with certain medical conditions.

How is TB Disease Treated?

TB disease can be treated by taking several drugs for 6 to 12 months. It is very important that people who have TB disease finish the medicine, and take the drugs exactly as prescribed. If they stop taking the drugs too soon, they can become sick again; if they do not take the drugs correctly, the germs that are still alive may become resistant to those drugs. TB that is resistant to drugs is harder and more expensive to treat. In some situations, staff of the local health department meet regularly with patients who have TB to watch them take their medications. This is called directly observed therapy (DOT). DOT helps the patient complete treatment in the least amount of time.

Additional Information

CDC. Questions and Answers About TB.

Learn About Tuberculosis | American Lung Association

Tuberculosis (TB) is an airborne bacterial infection caused by the organism Mycobacterium tuberculosis that primarily affects the lungs, although other organs and tissues may be involved.

Key Points

• While contagious, TB is not easily spread from person to person.
• About 1.8 billion people, or one-quarter of the world’s population, are infected with tuberculosis but most of these people have latent TB.
• About 10 million people have active TB worldwide.
• In the United States, TB is much less common.TB can almost always be treated and cured if you take medicine as directed.

How TB Affects Your Body

TB is caused by the bacterium M. tuberculosis. It spreads person to person when an infected individual coughs or sneezes out the bacteria, spreading it through the air to be breathed in by others. It takes prolonged exposure to become infected with TB, so you would typically get sick from a close family member or co-worker, not a casual acquaintance. Once you have inhaled the bacterium, the bacterium lodges in the lung tissue.

Healthy individuals may contract latent TB, but the disease may not become active until months or years later, at a time when the immune system becomes weak for some reason. However, people with weakened immune systems are at a greater risk for developing active TB right away. When they breathe in the bacterium, it settles in their lungs and starts growing because their immune systems cannot fight the infection. In these instances, TB disease may develop within days or weeks after the infection.

When a person gets active TB disease, it means TB bacteria are multiplying and attacking the lung(s) or other parts of the body, such as the lymph nodes, bones, kidney, brain, spine and even the skin. From the lungs, TB bacteria move through the blood or lymphatic system to different parts of the body.

Who Is at Risk of TB?

The chances of getting infected by the TB germ are highest for people that are in close contact with others who are infected. This includes:

• Family and friends of a person who is infected
• People from parts of the world with high TB rates, including India and parts of Asia and Africa. 
• People in groups with high rates of TB transmission, including the homeless, injection drug users and people living with HIV
• People who work or reside in facilities that house high risk people such as hospitals, homeless shelters, correctional facilities, nursing homes and residential homes for those with HIV

Not everyone who is infected with the TB germ (latent TB) develops clinically active TB disease. People at the highest risk for developing active TB disease are those with a weak immune system, including:

• Babies and young children
• People with chronic conditions such as diabetes or kidney disease
• People with HIV/AIDS
• Organ transplant recipients
• Cancer patients undergoing chemotherapy
• People receiving certain treatments for autoimmune disorders such as rheumatoid arthritis or Crohn’s disease

Tuberculosis – Symptoms and causes

Overview

Tuberculosis (TB) is a potentially serious infectious disease that mainly affects the lungs. The bacteria that cause tuberculosis are spread from person to person through tiny droplets released into the air via coughs and sneezes.

Once rare in developed countries, tuberculosis infections began increasing in 1985, partly because of the emergence of HIV, the virus that causes AIDS. HIV weakens a person’s immune system, so it can’t fight the TB germs. In the United States, because of stronger control programs, tuberculosis began to decrease again in 1993. But it remains a concern.

Many tuberculosis strains resist the drugs most used to treat the disease. People with active tuberculosis must take many types of medications for months to get rid of the infection and prevent antibiotic resistance.

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Symptoms

Although your body can harbor the bacteria that cause tuberculosis, your immune system usually can prevent you from becoming sick. For this reason, doctors make a distinction between:

• Latent TB. You have a TB infection, but the bacteria in your body are inactive and cause no symptoms. Latent TB, also called inactive TB or TB infection, isn’t contagious. Latent TB can turn into active TB, so treatment is important.
• Active TB. Also called TB disease, this condition makes you sick and, in most cases, can spread to others. It can occur weeks or years after infection with the TB bacteria.

Signs and symptoms of active TB include:

• Coughing for three or more weeks
• Coughing up blood or mucus
• Chest pain, or pain with breathing or coughing
• Unintentional weight loss
• Fatigue
• Fever
• Night sweats
• Chills
• Loss of appetite

Tuberculosis can also affect other parts of your body, including the kidneys, spine or brain. When TB occurs outside your lungs, signs and symptoms vary according to the organs involved. For example, tuberculosis of the spine might cause back pain, and tuberculosis in your kidneys might cause blood in your urine.

When to see a doctor

See your doctor if you have a fever, unexplained weight loss, drenching night sweats or a persistent cough. These are often indications of TB but can also result from other conditions. Also, see your doctor if you think you’ve been exposed to TB.

The Centers for Disease Control and Prevention recommends that people who have an increased risk of tuberculosis be screened for latent TB infection. This recommendation includes people who:

• Have HIV/AIDS
• Use IV drugs
• Are in contact with infected people
• Are from a country where TB is common, such as several countries in Latin America, Africa and Asia
• Live or work in areas where TB is common, such as prisons or nursing homes
• Work in health care and treat people with a high risk of TB
• Are children who are exposed to adults at risk of TB

Causes

Tuberculosis is caused by bacteria that spread from person to person through microscopic droplets released into the air. This can happen when someone with the untreated, active form of tuberculosis coughs, speaks, sneezes, spits, laughs or sings.

Although tuberculosis is contagious, it’s not easy to catch. You’re much more likely to get tuberculosis from someone you live or work with than from a stranger. Most people with active TB who’ve had appropriate drug treatment for at least two weeks are no longer contagious.

HIV and TB

Since the 1980s, tuberculosis cases have increased dramatically because of the spread of HIV, the virus that causes AIDS. HIV suppresses the immune system, making it difficult for the body to control TB bacteria. As a result, people with HIV are much more likely to get TB and to progress from latent to active disease than are people who aren’t HIV positive.

Drug-resistant TB

Tuberculosis also remains a major killer because of the increase in drug-resistant strains. Over time, some TB germs have developed the ability to survive despite medications. This is partly because people don’t take their drugs as directed or don’t complete the course of treatment.

Drug-resistant strains of tuberculosis emerge when an antibiotic fails to kill all of the bacteria it targets. The surviving bacteria become resistant to that drug and often other antibiotics as well. Some TB bacteria have developed resistance to the most commonly used treatments, such as isoniazid and rifampin (Rifadin, Rimactane).

Some TB strains have also developed resistance to drugs less commonly used in TB treatment, such as the antibiotics known as fluoroquinolones, and injectable medications including amikacin and capreomycin (Capastat). These medications are often used to treat infections that are resistant to the more commonly used drugs.

Risk factors

Anyone can get tuberculosis, but certain factors can increase your risk, including:

Weakened immune system

A healthy immune system often successfully fights TB bacteria. However, several conditions and medications can weaken your immune system, including:

• HIV/AIDS
• Diabetes
• Severe kidney disease
• Certain cancers
• Cancer treatment, such as chemotherapy
• Drugs to prevent rejection of transplanted organs
• Some drugs used to treat rheumatoid arthritis, Crohn’s disease and psoriasis
• Malnutrition or low body weight
• Very young or advanced age

Traveling or living in certain areas

Your risk of getting tuberculosis is higher if you live in, emigrate from or travel to areas with high tuberculosis rates. Areas include:

• Africa
• Asia
• Eastern Europe
• Russia
• Latin America

Other factors

• Using substances. IV drugs or excessive alcohol use weakens your immune system and makes you more vulnerable to tuberculosis.
• Using tobacco. Tobacco use greatly increases the risk of getting TB and dying of it.
• Working in health care. Regular contact with people who are ill increases your chances of exposure to TB bacteria. Wearing a mask and frequent hand-washing greatly reduce your risk.
• Living or working in a residential care facility. People who live or work in prisons, homeless shelters, psychiatric hospitals or nursing homes are all at a higher risk of tuberculosis due to overcrowding and poor ventilation.
• Living with someone infected with TB. Close contact with someone who has TB increases your risk.

Complications

Without treatment, tuberculosis can be fatal. Untreated active disease typically affects your lungs, but it can affect other parts of your body, as well.

Tuberculosis complications include:

• Spinal pain. Back pain and stiffness are common complications of tuberculosis.
• Joint damage. Arthritis that results from tuberculosis (tuberculous arthritis) usually affects the hips and knees.
• Swelling of the membranes that cover your brain (meningitis). This can cause a lasting or intermittent headache that occurs for weeks and possible mental changes.
• Liver or kidney problems. Your liver and kidneys help filter waste and impurities from your bloodstream. Tuberculosis in these organs can impair their functions.
• Heart disorders. Rarely, tuberculosis can infect the tissues that surround your heart, causing inflammation and fluid collections that might interfere with your heart’s ability to pump effectively. This condition, called cardiac tamponade, can be fatal.

Prevention

If you test positive for latent TB infection, your doctor might advise you to take medications to reduce your risk of developing active tuberculosis. Only active TB is contagious.

Protect your family and friends

If you have active TB, it generally takes a few weeks of treatment with TB medications before you’re not contagious anymore. Follow these tips to help keep your friends and family from getting sick:

• Stay home. Don’t go to work or school or sleep in a room with other people during the first few weeks of treatment.
• Ventilate the room. Tuberculosis germs spread more easily in small closed spaces where air doesn’t move. If it’s not too cold outdoors, open the windows and use a fan to blow indoor air outside.
• Cover your mouth. Use a tissue to cover your mouth anytime you laugh, sneeze or cough. Put the dirty tissue in a bag, seal it and throw it away.
• Wear a face mask. Wearing a face mask when you’re around other people during the first three weeks of treatment may help lessen the risk of transmission.

Finish your medication

This is the most important step you can take to protect yourself and others from tuberculosis. When you stop treatment early or skip doses, TB bacteria have a chance to develop mutations that allow them to survive the most potent TB drugs. The resulting drug-resistant strains are deadlier and more difficult to treat.

Vaccinations

In countries where tuberculosis is more common, infants often are vaccinated with bacille Calmette-Guerin (BCG) vaccine. The BCG vaccine isn’t recommended for general use in the United States because it isn’t very effective in adults. Dozens of new TB vaccines are in various stages of development and testing.

Tuberculosis (TB) | Cedars-Sinai

Not what you’re looking for?

What is tuberculosis?

Tuberculosis (TB) is a bacterial
infection that often infects the lungs. Other organs such as the kidneys, spine, or
brain may also be affected. TB is mainly spread from person to person through the
air,
such as when an infected person coughs or sneezes. It can also cause an active infection
after not being active in someone who was exposed at an earlier time.

There is a difference between being
infected with TB bacteria and having active tuberculosis disease.

The stages of TB are:

1. Exposure. This happens when a person
   has been in contact with, or exposed to, another person who has TB. The exposed
   person will have a negative skin test, a normal chest X-ray, and no signs or symptoms
   of the disease.
2. Latent TB infection. This happens
   when a person has TB bacteria in their body but no symptoms of the disease. The
   infected person’s immune system walls off the TB organisms. And the TB stays inactive
   throughout life in most people who are infected. This person would have a positive
   skin or blood test for TB but a normal chest X-ray or one that only shows past
   scarring from the disease. They would have no signs of active infection in other
   parts of the body.
3. TB disease. This person has signs and
   symptoms of an active TB infection. The person could have a positive or negative skin
   or blood test for TB and a positive chest X-ray, biopsy, or other finding showing
   an
   active infection.

What causes TB?

The main TB bacterium is
Mycobacterium tuberculosis (M. tuberculosis). Many people infected with this bacterium
never have active TB. They remain in the inactive (latent) TB stage. But some will
develop active TB anytime from months to years, or even decades, after being exposed.
The chance of developing active TB increases in babies and children and in older adults.
It also increases in people with a weak immune system, especially those with HIV.
Or in
those getting medicines that suppress the immune system.

The TB bacterium is spread through
the air when an infected person coughs, sneezes, speaks, sings, or laughs. It’s very
unlikely to be spread from personal items that a person with TB has touched. Good
ventilation can limit the spread of TB to other people. But early diagnosis and
treatment of the person with active TB is most important. It’s also important to limit
other people’s exposure. This means using masks and respiratory isolation.

Who is at risk for TB?

TB affects all ages, races, income
levels, and genders. Those at higher risk include:

• People who live or work with others
  who have TB
• Those who can’t access healthcare
• Homeless people
• People from countries where TB is more
  common
• People in group settings, such as
  nursing homes
• People who abuse alcohol
• People who use injection drugs
• People with a weak immune system,
  including those who have HIV, cancer, a transplant, or are taking medicines that
  suppress the immune system
• Very young children and older
  adults
• Healthcare workers who come in contact
  with high-risk populations

What are the symptoms of TB?

Each person’s symptoms may vary.
The most common symptoms of active TB include:

• Prolonged cough lasting weeks
• Chest pain
• Feeling tired and weak (fatigue)
• Loss of appetite
• Unintended weight loss
• Poor growth in children
• Fever
• Coughing blood or sputum
• Night sweats
• Shortness of breath
• Back pain

The symptoms of TB may look like
other lung conditions or health problems. Talk with a healthcare provider for a
diagnosis.

How is TB diagnosed?

TB infection is often diagnosed
with a skin or blood test. In the skin test (called a PPD), a small amount of testing
material is injected into the top layer of the skin. If a certain size bump develops
within 2 or 3 days, the test may be positive for TB infection. A blood test called
QuantiFERON may also be used. Other tests that may be key for diagnosing TB include
X-rays and sputum tests.

TB skin or blood tests are
suggested for people:

• In high-risk categories
• Who live or work in areas where TB is
  more common or are in close contact with people who have—or are at high risk
  for—TB
• Who have never had a TB skin or blood
  test

In children, the American Academy
of Pediatrics recommends testing:

• If the child may have been exposed in
  the last 5 years
• If the child has an X-ray that looks
  like TB
• If the child has any TB symptoms
• If the child comes from a country
  where TB is common
• For children living with HIV
• For children receiving medicines that
  suppress the immune system
• For children who are in detention
  facilities
• For children who are exposed to
  high-risk people
• If the child’s parent has come from a
  high-risk country
• If the child has traveled to high-risk
  areas
• If the child lives in a densely
  populated area

How is TB treated?

Treatment may vary depending on if
you have latent or active TB. Treatment may include:

• Short-term hospital stay.
• For
  latent TB.
  Often a 3- to 9-month course of 1 or 2 antibiotics will be given to
  kill off the TB organisms in the body. The most common antibiotics prescribed are
  isoniazid, rifapentine, and rifampin. Your healthcare provider can review the
  treatment options. They may recommend one as the best option for you, taking into
  account many factors.
• For
  active TB.
  Your healthcare provider may prescribe 2 to 4 or more antibiotics
  in combination for 6 to 9 months or longer. Examples include isoniazid, rifampin,
  pyrazinamide, and ethambutol. People often begin to improve within a few weeks of
  starting treatment. After several weeks of treatment with the correct medicines, the
  person is often no longer contagious. But medicine must be finished for the greatest
  chance of cure, as prescribed by a healthcare provider.

What are possible complications of TB?

If TB of the lung is not treated
early or if treatment isn’t followed, long-lasting (permanent) lung damage can result.
TB can also cause infection of the bones, spine, brain and spinal cord, lymph glands,
and other parts of the body. It can damage those areas and cause short-term (temporary)
or permanent symptoms from the damage. Uncontrolled TB can lead to death. And TB remains
one of the leading infectious causes of death worldwide.

What can I do to prevent TB?

If you will be spending time with
anyone with active TB, wear a strongly filtering face mask. And try not to stay in
a
small enclosed space with poor ventilation. People who work in situations where there
is
a high risk for contact with people infected with TB should be tested for TB on a
routine basis. This includes healthcare and shelter workers. In countries outside
the
U.S. where TB is more common, a childhood vaccine is often given. But it’s not clear
how
well it works.

When should I call my healthcare provider?

Let your healthcare provider know
if your symptoms get worse or you get new symptoms.

Key points about tuberculosis

• Tuberculosis is a bacterial infection
  that often infects the lungs.
• It may also affect the bones, spine,
  brain, lymph glands, and other parts of the body.
• Being infected with the TB bacteria is
  not the same as having active tuberculosis disease.
• There are 3 stages of TB: exposure,
  latent, and active disease.
• A TB skin test or a TB blood test can
  often diagnose the infection. But other testing is also often needed.
• Treatment exactly as recommended is
  needed to cure the disease and prevent its spread to other people.

Next steps

Tips to help you get the most from a visit to your healthcare
provider:

• Know the reason for your visit and
  what you want to happen.
• Before your visit, write down
  questions you want answered.
• Bring someone with you to help you ask
  questions and remember what your provider tells you.
• At the visit, write down the name of a
  new diagnosis and any new medicines, treatments, or tests. Also write down any new
  instructions your provider gives you.
• Know why a new medicine or treatment
  is prescribed and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated
  in other ways.
• Know why a test or procedure is
  recommended and what the results could mean.
• Know what to expect if you do not take
  the medicine or have the test or procedure.
• If you have a follow-up appointment,
  write down the date, time, and purpose for that visit.
• Know how you can contact your provider
  if you have questions.

Medical Reviewer: Barry Zingman MD

Medical Reviewer: Raymond Turley Jr PA-C

Medical Reviewer: L Renee Watson MSN RN

© 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.

Not what you’re looking for?

Symptoms, Causes, Treatment, and Prevention

What Is Tuberculosis?

Tuberculosis (TB) is a contagious infection that usually attacks your lungs. It can also spread to other parts of your body, like your brain and spine. A type of bacteria called Mycobacterium tuberculosis causes it.

Can tuberculosis be cured?

In the 20^th century, TB was a leading cause of death in the United States. Today, most cases are cured with antibiotics. But it takes a long time. You have to take medications for at least 6 to 9 months.

Tuberculosis Types

A TB infection doesn’t always mean you’ll get sick. There are two forms of the disease:

• Latent TB. You have the germs in your body, but your immune system keeps them from spreading. You don’t have any symptoms, and you’re not contagious. But the infection is still alive and can one day become active. If you’re at high risk for re-activation — for instance, if you have HIV, you had an infection in the past 2 years, your chest X-ray is unusual, or your immune system is weakened — your doctor will give you medications to prevent active TB.  
• Active TB. The germs multiply and make you sick. You can spread the disease to others. Ninety percent of active cases in adults come from a latent TB infection.

A latent or active TB infection can also be drug-resistant, meaning certain medications don’t work against the bacteria.

Tuberculosis Signs and Symptoms

Latent TB doesn’t have symptoms. A skin or blood test can tell if you have it.

Signs of active TB disease include:

If you have any of these symptoms, see your doctor to get tested. Get medical help right away if you have chest pain.

Tuberculosis Causes

Tuberculosis is caused by bacteria that spread through the air, just like a cold or the flu. You can get TB only if you come into contact with people who have it.

Tuberculosis Risk Factors

You could be more likely to get TB if:

• A friend, co-worker, or family member has active TB.
• You live in or have traveled to an area where TB is common, like Russia, Africa, Eastern Europe, Asia, Latin America, and the Caribbean.
• You’re part of a group in which TB is more likely to spread, or you work or live with someone who is. This includes homeless people, people who have HIV, people in jail or prison, and people who inject drugs into their veins.
• You work or live in a hospital or nursing home.
• You’re a health care worker for patients at high risk of TB.
• You’re a smoker.

A healthy immune system fights the TB bacteria. But you might not be able to fend off active TB disease if you have:

Babies and young children also have higher chances of getting it because their immune systems aren’t fully formed.

Tuberculosis Transmission

When someone who has TB coughs, sneezes, talks, laughs, or sings, they release tiny droplets that contain the germs. If you breathe in these germs, you can get it.

TB isn’t easy to catch. You usually have to spend a long time around someone who has a lot of the bacteria in their lungs. You’re most likely to catch it from co-workers, friends, and family members.

Tuberculosis germs don’t thrive on surfaces. You can’t get it from shaking hands with someone who has it or by sharing their food or drink. 

Tuberculosis Tests and Diagnosis

There are two common tests for tuberculosis:

• Skin test. This is also known as the Mantoux tuberculin skin test. A technician injects a small amount of fluid into the skin of your lower arm. After 2 or 3 days, they’ll check for swelling in your arm. If your results are positive, you probably have TB bacteria. But you could also get a false positive. If you’ve gotten a tuberculosis vaccine called bacillus Calmette-Guerin (BCG), the test could say that you have TB when you really don’t. The results can also be false negative, saying that you don’t have TB when you really do, if you have a very new infection. You might get this test more than once.
• Blood test. These tests, also called interferon-gamma release assays (IGRAs), measure the response when TB proteins are mixed with a small amount of your blood.

Those tests don’t tell you if your infection is latent or active. If you get a positive skin or blood test, your doctor will learn which type you have with:

• A chest X-ray or CT scan to look for changes in your lungs
• Acid-fast bacillus (AFB) tests for TB bacteria in your sputum, the mucus that comes up when you cough

Tuberculosis Treatment

Your treatment will depend on your infection.

• If you have latent TB, your doctor will give you medication to kill the bacteria so the infection doesn’t become active. You might get isoniazid, rifapentine, or rifampin, either alone or combined. You’ll have to take the drugs for up to 9 months. If you see any signs of active TB, call your doctor right away.
• A combination of medicines also treats active TB. The most common are ethambutol, isoniazid, pyrazinamide, and rifampin. You’ll take them for 6 to 12 months.
• If you have drug-resistant TB, your doctor might give you one or more different medicines. You may have to take them for much longer, up to 30 months, and they can cause more side effects.

Whatever kind of infection you have, it’s important to finish taking all of your medications, even when you feel better. If you quit too soon, the bacteria can become resistant to the drugs.

Tuberculosis Medication Side Effects

Like any medication, TB drugs can have side effects.

Common isoniazid side effects include:

• Numbness and tingling in your hands and feet
• Upset stomach, nausea, and vomiting
• Loss of appetite
• Weakness

Ethambutol side effects may include:

• Chills
• Painful or swollen joints
• Belly pain, nausea, and vomiting
• Loss of appetite
• Headache
• Confusion

Some pyrazinamide side effects include:

• Lack of energy
• Nausea and vomiting
• Loss of appetite
• Muscle or joint pain

Common rifampin side effects include:

• Skin rash
• Upset stomach, nausea, and vomiting
• Diarrhea
• Loss of appetite
• Inflamed pancreas

Tuberculosis Complications

Tuberculosis infection can cause complications such as:

• Joint damage
• Lung damage
• Infection or damage of your bones, spinal cord, brain, or lymph nodes
• Liver or kidney problems
• Inflammation of the tissues around your heart

Tuberculosis Prevention

To help stop the spread of TB:

• If you have a latent infection, take all of your medication so it doesn’t become active and contagious.
• If you have active TB, limit your contact with other people. Cover your mouth when you laugh, sneeze, or cough. Wear a surgical mask when you’re around other people during the first weeks of treatment.
• If you’re traveling to a place where TB is common, avoid spending a lot of time in crowded places with sick people.

Tuberculosis vaccine

Children in countries where TB is common often get the BCG vaccine. It isn’t widely used in the United States, and it doesn’t always protect against infection. Doctors recommend it only for children living with someone who has an active TB infection with a very drug-resistant strain or who can’t take antibiotics.

Other vaccines are being developed and tested.

Tuberculosis Outlook

Your outlook depends on several things, including your overall health, how severe the infection is, and how well you follow your doctor’s directions on treatment. In the United States, experts estimate that treatment works in more than 95% of cases.

Tuberculosis (TB) – NHS

Tuberculosis (TB) is a bacterial infection spread through inhaling tiny droplets from the coughs or sneezes of an infected person.

It mainly affects the lungs, but it can affect any part of the body, including the tummy (abdomen), glands, bones and nervous system.

TB is a potentially serious condition, but it can be cured if it’s treated with the right antibiotics.

Symptoms of TB

Typical symptoms of TB include:

• a persistent cough that lasts more than 3 weeks and usually brings up phlegm, which may be bloody
• weight loss
• night sweats
• high temperature
• tiredness and fatigue
• loss of appetite
• swellings in the neck

You should see a GP if you have a cough that lasts more than 3 weeks or you cough up blood.

Read more about the symptoms of TB and diagnosing TB.

What causes TB?

TB is a bacterial infection. TB that affects the lungs (pulmonary TB) is the most contagious type, but it usually only spreads after prolonged exposure to someone with the illness. 

In most healthy people, the body’s natural defence against infection and illness (the immune system) kills the bacteria and there are no symptoms.

Sometimes the immune system cannot kill the bacteria, but manages to prevent it 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.

If the immune system fails to kill or contain the infection, it can spread within the lungs or other parts of the body and symptoms will develop within a few weeks or months. This is known as active TB.

Latent TB could develop into an active TB disease at a later date, particularly if your immune system becomes weakened.

Read more about the causes of TB

Treating TB

With treatment, TB can almost always be cured. A course of antibiotics will usually need to be taken for 6 months.

Several different antibiotics are used because some forms of TB are resistant to certain antibiotics.

If you’re infected with a drug-resistant form of TB, treatment with 6 or more different medications may be needed.

If you’re diagnosed with pulmonary TB, you’ll be contagious for about 2 to 3 weeks into your course of treatment.

You will not usually need to be isolated during this time, but it’s important to take some basic precautions to stop the infection spreading to your family and friends.

You should:

• stay away from work, school or college until your TB treatment team advises you it’s safe to return
• always cover your mouth when coughing, sneezing or laughing
• carefully dispose of any used tissues in a sealed plastic bag
• open windows when possible to ensure a good supply of fresh air in the areas where you spend time
• avoid sleeping in the same room as other people 

If you’re in close contact with someone who has TB, you may have tests to see whether you’re also infected. These can include a chest X-ray, blood tests, and a skin test called the Mantoux test.

Read more about treating TB

Vaccination for TB

The BCG vaccine offers protection against TB, and is recommended on the NHS for babies, children and adults under the age of 35 who are considered to be at risk of catching TB.

The BCG vaccine is not routinely given to anyone over the age of 35 as there’s no evidence that it works for people in this age group.

At-risk groups include:

• children living in areas with high rates of TB
• people with close family members from countries with high TB rates
• people going to live and work with local people for more than 3 months in an area with high rates of TB

If you’re a healthcare worker or NHS employee and you come into contact with patients or clinical specimens, you should also have a TB vaccination, irrespective of age, if:

Read more about who should have the BCG vaccine

Countries with high TB rates

Parts of the world with high rates of TB include:

• Africa – particularly sub-Saharan Africa (all the African countries south of the Sahara desert) and west Africa
• south Asia – including India, Pakistan, Indonesia and Bangladesh
• Russia
• China
• South America
• the western Pacific region (to the west of the Pacific Ocean) – including Vietnam, Cambodia and the Philippines 

GOV.UK has detailed information on each country’s TB rates

Page last reviewed: 12 November 2019
Next review due: 12 November 2022

Tuberculosis TB | Johns Hopkins Medicine

What is TB?

Tuberculosis, or TB, is a bacterial infection that usually infects the lungs. Other organs, such as the kidneys, spine, or brain may also be involved. TB is primarily spread from person to person in an airborne manner, such as when an infected person coughs or sneezes. It can also cause an active infection after a period of not being active in someone who was exposed at an earlier time.

There is a difference between being infected with the TB bacterium and having active tuberculosis disease.

The following are the stages of TB:

1. Exposure. This happens when a person has been in contact with, or exposed to, another person who has TB. The exposed person will have a negative skin test, a normal chest X-ray, and no signs or symptoms of the disease.
2. Latent TB infection. This happens when a person has TB bacteria in his or her body, but does not have symptoms of the disease. The infected person’s immune system walls off the TB organisms, and the TB remains inactive throughout life in most people who are infected. This person would have a positive skin test, but a normal chest X-ray.
3. TB disease. This describes the person who has signs and symptoms of an active infection. The person would have a positive skin test and a positive chest X-ray.

What causes TB?

The main TB bacterium is Mycobacterium tuberculosis (M. tuberculosis). Many people infected with this bacterium never develop active TB. They remain in the latent (inactive) TB stage. However, in people with weak immune systems, especially those with HIV (human immunodeficiency virus), or those receiving medicines that suppress the immune system, TB organisms can overcome the body’s defenses, multiply, and cause an active disease.

The TB bacterium is spread through the air when an infected person coughs, sneezes, speaks, sings, or laughs. It’s not likely to be spread through personal items, such as clothing, bedding, a drinking glass, eating utensils, a handshake, a toilet, or other items that a person with TB has touched. Good ventilation is the most important measure to prevent the transmission of TB.

Who is at risk for TB?

TB affects people of all ages, races and income levels. Those at higher risk include the following:

• People who live or work with others who have TB
• Those who can’t access health care
• Homeless people
• People from other countries where TB is prevalent
• People in group settings, such as nursing homes
• People who abuse alcohol
• People who use intravenous drugs
• People with weak immune systems
• The elderly
• Healthcare workers who come in contact with high-risk populations

What are the symptoms of TB?

The following are the most common symptoms of active TB. However, each person may experience symptoms differently:

• Cough that lasts 3 weeks or longer
• Chest pain
• Fatigue
• Loss of appetite
• Unintended weight loss
• Poor growth in children
• Fever
• Coughing blood or sputum
• Chills or night sweats

The symptoms of TB may look like other lung conditions or medical problems. Talk with a healthcare provider for a diagnosis.

How is TB diagnosed?

TB is often diagnosed with a skin test. In this test, a small amount of testing material is injected into the top layer of the skin. If a certain size bump develops within 2 or 3 days, the test may be positive for tuberculosis infection. Other tests include X-rays and sputum tests. A blood test can be done in place of the TB skin test.

TB skin tests are suggested for those:

• In high-risk categories
• Who live or work in close contact with people who are at high risk
• Who have never had a TB skin test

For skin testing in children, the American Academy of Pediatrics recommends testing:

• If the child is thought to have been exposed in the last 5 years
• If the child has an X-ray that looks like TB
• If the child has any symptoms of TB
• If the child comes from a country where TB is prevalent
• For children with HIV
• For children receiving medicines that suppress the immune system
• For children who are in detention facilities
• For children who are exposed to high-risk people
• If the child’s parent has come from a high-risk country
• If the child has traveled to high-risk areas
• If the child lives in a densely populated area

How is TB treated?

Your healthcare provider will figure out the best treatment for you based on:

• How old you are
• Your overall health and past health
• How sick you are
• How well you can handle specific medicines, procedures, or therapies
• How long the condition is expected to last
• Your opinion or preference

Treatment may include:

• Short-term hospitalization
• For latent TB which is newly diagnosed: Usually a 6 to 12 month course of antibiotic called isoniazid will be given to kill off the TB organisms in the body. Some people with latent TB may be treated with a shorter course of 2 antibiotics for only 3 months.
• For active TB: Your healthcare provider may prescribe 3 or more antibiotics in combination for 6 to 9 months or longer. Examples include: isoniazid, rifampin, pyrazinamide, and ethambutol. People usually begin to improve within a few weeks of the start of treatment. After several weeks of treatment with the correct medicines, the person is usually no longer contagious, if treatment is carried through to the end, as prescribed by a healthcare provider.

What are the complications of TB?

If TB is not treated early or if treatment isn’t followed, permanent lung damage can result.

Can TB be prevented?

If you will be spending time with a person or people with active TB, wear a face mask and try not to stay in a small enclosed space with poor ventilation. People who work in situations where there is a high risk for encountering people infected with TB, such as healthcare workers, should be tested for TB on a routine basis. In countries outside the U.S. where TB is more common, a childhood vaccine is often given.

When should I call my healthcare provider?

If your symptoms get worse or you get new symptoms, let your healthcare provider know.

Key points about TB

• Tuberculosis is a bacterial infection that usually infects the lungs.
• It may also affect the kidneys, spine, and brain.
• Being infected with the TB bacterium is not the same as having active tuberculosis disease.
• There are 3 stages of TB—exposure, latent, and active disease.
• A TB skin test or a TB blood test can diagnose the disease.
• Treatment exactly as recommended is necessary to cure the disease and prevent its spread to other people.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.

Pulmonary and extrapulmonary tuberculosis – Ravijuhend

This patient guide is based on the 2017 Estonian treatment guide “Management of patients with pulmonary and extrapulmonary tuberculosis” and the topics presented therein together with recommendations. In this manual, you will find the recommendations that are most important from the patient’s point of view. The guide provides an overview of the main problems associated with the disease.

The manual is intended for people with tuberculosis, as well as for their loved ones and health care workers.This guide will help patients and their loved ones cope better with their illness, provide answers to the most frequently asked questions about treatment and daily problems, and can support patients and their loved ones during the treatment process. The Patient Guide provides an overview of tuberculosis as a disease, the tests used for diagnosis, treatment, and the organization of a daily regimen during a controlled treatment process.

The guidelines were compiled by experts in the field, along with former patients who have previously experienced and recovered from tuberculosis.The importance of the topics described in the manual and the clarity of the text have been appreciated by TB patients and their families. Patient feedback and feedback has been instrumental in the development of this manual and has helped to improve it.

You can learn more about the topics covered in this patient guide by following the links at the end of the guide.

Tuberculosis is an infectious disease caused by a bacteria called Mycobacterium tuberculosis .The causative agents of tuberculosis are spread by airborne droplets. When a tuberculosis patient coughs, sneezes, singing or talking, together with droplets of saliva, tuberculosis pathogens are thrown into the air, which can be inhaled by other people nearby. As a result, a person can become infected with tuberculosis. One untreated TB patient can infect up to 10-15 people a year.

Not all people who have come into contact with an infectious (ie contagious) TB patient can develop TB.The more tuberculosis pathogens are thrown into the air by the carrier of the disease and the denser and longer contact with him, the more the likelihood of the spread of tuberculosis increases. Of all those in close contact with an infectious TB patient (family members, friends and colleagues who are with the patient every day), approximately one third will become infected. It is impossible to get sick with TB, for example, by shaking hands, using the same dishes or the same toilet room.

Tuberculosis can damage all organs of a person, but most often the lungs are the focus of the disease.Of other organs, the disease can most often affect the pleura of the lungs, bones and joints, as well as the kidneys. This form of tuberculosis, in which the lungs themselves are not damaged, is called extrapulmonary tuberculosis, and patients with this disease are usually not contagious. At the same time, in the case of patients with extrapulmonary tuberculosis, it is very important to adhere to the prescribed course of treatment and bring treatment to the end.

All people can become infected with TB, regardless of their financial income or social status.Thus, the assumption that TB only affects people with a low standard of living is incorrect.

In 2016, 190 patients were diagnosed with TB in Estonia, of which 166 contracted TB for the first time. In 31 patients, tuberculosis was found not only in the lungs, but also in other organs. Extrapulmonary tuberculosis alone was diagnosed in 15 patients in 2016. Children rarely get sick in Estonia; up to 10 cases of the disease are diagnosed a year.

In case of infection (infection) with tuberculosis, viable but inactive tuberculosis bacteria enter the human body. In most cases, the body’s protective immune system is able to prevent the spread of bacteria in the body. People who become infected with tuberculosis feel healthy, have no symptoms of the disease, and do not spread tuberculosis to others.Infection with tuberculosis can be diagnosed with a blood test (determination of the level of interferon gamma of the causative agent of tuberculosis M. tuberculosis in the blood) or with a tuberculin test (tuberculin test).

The risk of contracting tuberculosis after infection is approximately 5–15%. The risk of getting sick is highest precisely within two years after infection, but you can get sick many years later if, for any reason, the person’s immune system weakened and can no longer keep the multiplication of tuberculosis bacteria.Therefore, it is very important that people who become infected with tuberculosis know how to track their symptoms, which are characteristic of tuberculosis, and if they are found, they immediately go to a doctor.

In some cases, a person who has become infected with tuberculosis is prescribed preventive treatment in order to prevent the further process of becoming ill with tuberculosis. Preventive treatment most often involves one anti-TB drug and treatment lasts six to nine months.

Tuberculosis can be contracted both immediately after infection and several years later.In a disease, the general condition of the human body plays an important role – malnutrition, mental stress, alcoholism, drug addiction, chronic diseases, and immune deficiency (including HIV infection) contribute to the disease. If the immune system of a person infected with tuberculosis is significantly weakened (for example, due to infection with HIV or another disease), then the viable tuberculosis bacteria in the body will begin to multiply and become the cause of tuberculosis. In the case of tuberculosis, the person develops characteristic symptoms and the person can spread the tuberculosis bacteria to others.

The risk of contracting tuberculosis after infection is higher in the following cases:

• in HIV-infected people
• for people with a transplanted organ or people who are waiting for a transplant
• in people with chronic renal failure who are receiving dialysis treatment
• in people with silicosis (a rare lung disease that occurs when silica is inhaled)
• for diabetics
• in people taking certain types of biological medications
• in persons in close contact with infectious people with tuberculosis

With tuberculosis, the type of symptoms depends on which organ was affected by the tuberculosis bacterium.

If the lungs are affected, the following symptoms may appear:

• cough lasting more than two weeks
• expectoration with purulent sputum or blood
• chest pain

The following symptoms can often occur:

• weakness, feeling of exhaustion
• decrease in appetite and body weight
• temperature rise
• increased sweating at night, chills

Photo: Scanpix

Sometimes TB can be asymptomatic.

In case of symptoms characteristic of tuberculosis, you should immediately contact your family doctor or pulmonologist. In case of suspicion of tuberculosis, you can go directly to the pulmonologist dealing with tuberculosis without asking for a referral from your family doctor. Tuberculosis screening tests are also free of charge for those without health insurance.

If tuberculosis is suspected in a child, then for the next examinations you need to consult a doctor dealing with infectious diseases of children.

If there is a suspicion of pulmonary tuberculosis, the doctor should ask the person about the symptoms of the disease and check if there have been any previous contacts with tuberculosis patients.Most often, X-rays are taken afterwards and at least two sputum samples are taken at different times. These sputum samples are sent for examination to detect the appearance of tuberculosis bacteria. In the event that a person cannot give a sputum test himself, expectoration can be caused (provoked) and for this inhalation with saline is done. Another option is to refer the person for a bronchoscopy or for a bronchial tract viewing procedure. Since young children do not know how to take a sputum test, instead of sputum, the fluid obtained after rinsing the stomach is examined.

Photo: Scanpix

A sputum test is primarily examined under a microscope. If during examination under a microscope (so-called microscopy) tuberculosis bacteria are found in the sputum, this means that there is an extensive secretion of bacteria and such a patient can be considered infectious. The attending physician can receive the results of microscopy the very next day after the tests. The sputum is then examined using the culture method, and it can take up to eight weeks to obtain the results of such an examination.The inoculation method can be used to definitively confirm the presence of tuberculosis bacteria if the excretion of bacteria was small. A patient in whom tuberculosis bacteria are found in sputum only using the culture method can also be infectious and infect others with tuberculosis bacteria.

In general, such patients are considered less infectious than those patients in whom tuberculosis bacteria are found in sputum immediately, upon the first examination under a microscope.Searching for tuberculosis bacteria in sputum using the culture method will help to finally confirm the diagnosis of tuberculosis. The inoculation method also determines the drug resistance of tuberculosis bacteria, and this will be the basis for drawing up a treatment regimen.

When diagnosing tuberculosis, rapid tests are also used, the results of which are clarified within a few days. Since it is impossible to determine the sensitivity of the tuberculosis pathogen to all drugs used in treatment with the help of express tests, an examination with a microscope and a seeding method is carried out in parallel.

In case of suspicion of tuberculosis, blood tests are also checked, sometimes computed tomography is done to assess more accurately the damage to the lungs or other organs, and its volume.

In Estonia, in case of suspected tuberculosis, all examinations are free of charge, regardless of the availability of health insurance.

If the tuberculosis bacterium is susceptible to the main drug against tuberculosis (that is, the drug destroys the bacterium), then the course of treatment lasts from six to nine months and treatment is started simultaneously with four to five different drugs. Most often, drugs are used in the form of tablets, but at the beginning of treatment, an injectable drug may also be present in the scheme. With proper medication, your doctor may reduce your daily medication after two or three months.

In case of drug sensitivity, the main drugs are:

• isoniazid
• rifampicin
• ethambutol
• pyrazinamide
• streptomycin

Photo: Scanpix

Tuberculosis is almost always curable, but full recovery requires strict adherence to the course of treatment prescribed by your doctor. The well-being of a patient with a drug-sensitive tuberculosis pathogen usually improves after a few weeks after starting treatment.Often during this period, a person is no longer infectious. And yet it is very important to remember that the multiplying pathogens of tuberculosis persist for some time in the body, even when the patient no longer has any problems and does not feel sick anymore. Therefore, for complete recovery, strict adherence to the tuberculosis treatment regimen is necessary throughout the entire period of treatment.

Untreated tuberculosis is still dangerous for people around, and especially for children and those with weakened immunity.

If the causative agent of tuberculosis cannot be destroyed by any specific drug, then this means that the bacterium is not sensitive to the drug, i.e.that is, it is resistant. If the causative agent of tuberculosis is resistant to the main two drugs for tuberculosis – isoniazid and rifampicin, then this form of the disease is called multidrug-resistant tuberculosis. Treatment for MDR-TB is more difficult and takes significantly longer than for drug-sensitive TB (one and a half to two years).

A person can become ill with drug-resistant tuberculosis in two ways:

• already initially infected with drug-resistant bacteria
• Drug resistance can develop during treatment when a patient does not take the prescribed drugs in the correct amount, with the necessary frequency and for a long time.

Five to seven drugs are used at the same time to treat MDR TB, and these drugs can cause more side effects.

In 2016, MDR TB was diagnosed in 24 patients in Estonia, of whom 17 contracted TB for the first time.

In the process of treating tuberculosis, the so-called Directly Observed Treatment (DOT) is used. DOT means that the patient must take the medication every day in the presence of the nurse, who directly checks if the medication has been taken.Usually tuberculosis treatment begins in the hospital, but after the infectious period passes, treatment can be continued on an outpatient basis, i.e. at home.

Photo: Scanpix

DOT tries to make it as convenient and accessible for the patient as possible. For example, a patient can be compensated for by public transportation to a hospital to receive medication. If the patient is allowed home treatment, but he cannot come to the nurse who monitors the treatment of tuberculosis, then the medicine is brought to the patient’s home.In the last months of the course of treatment, when the patient feels well and is no longer infectious, he can return to work or school and lead a normal life.

During treatment, the pulmonologist constantly monitors the patient’s course of treatment and the recovery process. To do this, new examinations of the composition of sputum are carried out every month, X-rays are repeated and, if necessary, blood tests are done.

Tuberculosis is a particularly dangerous infectious disease, which is dangerous both for the patient himself and for those around him.Based on this, those who refuse tuberculosis treatment or interrupt the course of treatment in Estonia can be sent for compulsory treatment for up to six months (182 days) to the Jamejala Tuberculosis Treatment Unit in Viljandi hospitals.

Tuberculosis medications can cause side effects. It is important that the patient monitors the occurrence of side effects during treatment and immediately informs the attending physician about them.Medicines for the treatment of side effects are provided by the attending physician to patients free of charge. Certain vitamins are given along with TB medicines to reduce the risk of side effects.

Lifestyle during TB treatment

If the patient has been transferred to outpatient treatment, then he can lead a normal life, leave the house and communicate with friends and acquaintances.It is important to adhere to the prescribed treatment regimen and the principles of a healthy diet. For a better course of the treatment process, it is advisable to give up unhealthy habits, such as drinking alcohol and cigarettes.

If the patient is no longer infectious, has no symptoms of the disease and the drugs do not cause side effects, then he can return to work or school and during treatment for tuberculosis. It is important to remember that it is imperative that the patient continue to receive DOT visits when returning to work or school.Therefore, during the treatment of tuberculosis, in general, the patient cannot leave for a long time from the place of treatment.

If the patient is not able to work during the treatment, then a certificate of incapacity for work is issued for him for this period. Compensation for the certificate of incapacity for work can be obtained in 240 calendar days and, if necessary, at the end of this period, you can apply for the appointment of a status of incapacity for work. To do this, you need to submit an application for an assessment of the work ability to the unemployment fund.A patient attending a high school can apply for a sabbatical leave for the duration of the treatment.

Photo: Scanpix

During TB treatment:

• Smoking interferes with the protective functions of the lungs and therefore slows down recovery
• Alcohol consumption during treatment can cause serious side effects
• after the period of infectious danger has passed, it is possible to restore sexual life
• pregnancy during this period is not desirable, and you should take into account that anti-tuberculosis drugs can weaken the effect of contraception.
• Sunbathing and tanning should be avoided, as the side effects of medications can cause age spots and increase the risk of sunburn
• Saunas are not prohibited, but very hot steam is contraindicated.
• You can eat all foods, good nutrition helps the healing process

Case management after tuberculosis treatment

A patient who has suffered tuberculosis caused by a tuberculosis agent sensitive to treatment, has completed the full cycle of treatment prescribed by the attending physician, and recovered, does not need regular medical supervision after recovery.And yet it is very important that this patient is able to monitor his own state of health himself and in case of symptoms of tuberculosis, he must turn to a pulmonologist or family doctor.

A patient who has had multidrug-resistant tuberculosis, who has HIV and does not adhere to the exact prescribed medication regimen, after recovery should be followed up for two years with a frequency of every six months. For observation, the patient must visit a pulmonologist and during each visit he will be asked questions about possible symptoms, take X-rays and check the sputum for the content of tuberculosis bacteria.

Photo: Scanpix

A patient with tuberculosis can protect their loved ones from the danger of infection if he:

• Takes tuberculosis medication strictly as prescribed by a doctor
• when coughing, turns his head away and covers his mouth with his hand or paper napkin
• will ask all persons in contact with him to see a doctor for a health check

In the case of each patient, the circle of persons in close contact with him, for whom the risk of infection is very high, is ascertained.To do this, the nurse observing a patient with tuberculosis asks him about those contacts who may be infected and who have a high risk of also contracting tuberculosis. Finding out who was in contact allows you to call people at risk for a medical examination and detect new cases of tuberculosis as early as possible.

If the patient himself does not want to inform his contacts about his illness, then this can be done by a medical officer. Informing the contact persons and inviting them to the examination should be delicate, and at the same time the name of the sick patient should not be mentioned.Both for the patient himself and for all persons in contact, all examinations related to tuberculosis are carried out free of charge, regardless of whether the person has health insurance. You do not need a referral from a family doctor for the examination.

For most people in contact, X-rays are taken and a blood test (determined by the level of interferon gamma M. tuberculosis) or a test for tuberculin. Sometimes a sputum composition is examined.

In some cases, prophylactic treatment is prescribed for persons who have come into contact with a patient with a drug-sensitive pathogen of tuberculosis, who have been found to be infected with tuberculosis.The goal of preventive treatment is to prevent tuberculosis. During preventive treatment, you need to take one essential TB drug almost every day for six to nine months. Before prophylactic treatment is prescribed, tests are always carried out to prevent tuberculosis.

Preventive treatment is prescribed, if necessary, after infection with tuberculosis:

• mothers of children under 5 years old
• for HIV-infected people in contact

90,016 people taking certain type of biological medications

90 016 people whose immune system is weakened due to any disease or its treatment

90,016 people with a transplanted organ or people who are in the waiting list for a transplant

Those who have come into contact with a patient with multidrug-resistant tuberculosis and who are infected as a result are not prescribed preventive treatment, since effective treatment regimens have not yet been developed for this case.To observe them, X-rays are taken every two years. Also, all persons who have been in contact with a patient with multidrug-resistant tuberculosis are trained to monitor their symptoms of tuberculosis.

1. Ai J-W, Ruan Q-L, Liu Q-H, Zhang W-H. Updates on the risk factors for latent tuberculosis reactivation and their managements. Emerg Microbes Infect. 2016 Feb; 5 (2): e10.
2. Landry J, Menzies D.Preventive chemotherapy. Where has it got us? Where to go next? Int J Tuberc Lung Dis Off J Int Union Tuberc Lung Dis. 2008 Dec; 12 (12): 1352–64.
3. Malaysia Health Technology Assessment Section Ministry of Health Malaysia. Management of Tuberculosis (3rd Edition). 2012.
4. Ministry of Science and Innovation, Spain. Clinical Practice Guideline on the Diagnosis, Treatment and Prevention of Tuberculosis. 2010.
5. National Institute for Health and Care Excellence.Tuberculosis. 2016.
6. Public Health Agency of Canada. Canadian Tuberculosis Standards 7th Edition. 2014.
7. TB CARE I. International Standards for Tuberculosis Care, Edition 3. The Hague: TB CARE I; 2014.
8. Viiklepp, P. Tuberkuloosihaigestumus Eestis 2012-2013. Tallinn: Tervise Arengu Instituut; 2014
9. World Health Organization. Global Tuberculosis Report 2016. Geneva: World Health Organization.
10. World Health Organization.Systematic screening for active tuberculosis: principles and recommendations. 2013.

1. On Health Information Portal
2. On the website of the Finnish Lung Health Society
3. On the medical portal inimene.ee
4. On the medical portal kliinik.ee
5. On the portal of the Institute for Health Development hiv.ee
6. Information brochures on tuberculosis published by the Institute for Health Development

Nutritional recommendations can be found on the website of the Institute for Health Development www.toitumine.ee.

Medical institutions that can be contacted in case of suspicion of tuberculosis

You do not need to ask a family doctor for a referral to receive an examination, and all examinations related to the detection of tuberculosis are free for those patients who do not have health insurance.

Tallinn
Polyclinic for Tuberculosis Treatment of the Pulmonary Center of the North Estonia Regional Hospital
Hiiu 39, Tallinn
Reception of adults and children – patients from Tallinn, Harju County and Raplamaa.
Reception phone 617 2929
Children’s office – phone 617 2951

Tartu
Admission to adults – patients from Tartu, Tartu County, Jõgeva County, Valgamaa, Põlvamaa
Polyclinic for Lung Diseases of the University of Tartu Clinic, Riia 167, Tartu
Pulmonologist’s office – phone 731 8949
Reception of children – patients from Tartu, Tartu County, Võrumaa, Jõgevamaa, Valgamaa, Põlvamaa
Children’s Clinic of the University of Tartu Clinic, Lunini 6, Tartu
Children’s office in Tartu – phone 731 9531

Jõgeva
Jõgeva Hospital, Piiri 2, Jõgeva
Reception phone 776 6220

Kohtla-Jarve
Polyclinic Ida-Viru Central Hospital, Ravi 10d, Kohtla-Järve
Reception phone number 339 5057, 331 1133

Narva
Narva Hospital Infectious Diseases Department, Haigla 5, Narva
Reception phone 357 2778
Pulmonologist’s office – phone 354 7900

Haapsalu
Läänema Hospital, Vaba 6, Haapsalu
Reception phone number 72 5800,
Pulmonologist’s office – phone – 472 5855

Kuressaare
Kuressaare Hospital, Aia 25, Kuressaare
Reception phone number 452 0115

Paide
Järvama Hospital, Tiigi 8, Paide
Registry phone 384 8132
Pulmonologist’s office – phone 384 8117

Pylva
Põlva Hospital, Uus 2, Põlva
Registry phone 799 9199

Pärnu
Pärnu Hospital, Ristiku 1, Pärnu
Reception phone 447 3300
Pulmonologist’s office – phone 447 3382

Rakvere
Rakvere Hospital, Lõuna Põik 1, Rakvere
Reception phone 322 9780
Pulmonologist’s office – phone 327 0188

Viljandi
Viljandi Hospital, Pärsti Rural Municipality, Viljandi County
Reception phone 434 3001
Pulmonologist’s office – phone 435 2053

Voru
South Estonian Hospital, Meegomäe village, Võru parish
Reception phone 786 8569
Pulmonologist’s office – phone 786 8591

Tuberculosis

Tuberculosis is caused by a bacterium ( Mycobacterium tuberculosis) , which most often affects the lungs.Tuberculosis is curable and preventable.

Tuberculosis spreads from person to person through the air. When people with pulmonary tuberculosis cough, sneeze, or expectorate, they release tuberculosis bacteria into the air. For a person to become infected, it is enough to inhale only a small amount of such bacteria.

About one quarter of the world’s population is infected with tuberculosis. This means that people are infected with the TB bacteria but are not (yet) sick and unable to transmit it.

The probability that people infected with tuberculosis bacteria will develop tuberculosis in their lifetime is 5-15%.People with weakened immune systems, such as people with HIV infection, people who are malnourished or people with diabetes, and people who use tobacco are at a much higher risk of the disease.

When a person develops active tuberculosis, symptoms (cough, fever, night sweats, or weight loss) may remain mild for many months. This can lead to delays in seeking medical attention and transmitting bacteria to others.For a year, a person with an active form of tuberculosis can infect 5-15 people with whom he has close contacts. Without proper treatment, on average 45% of HIV-negative people with TB and almost all HIV-positive people with TB die.

Who is most at risk?

Tuberculosis predominantly affects adults in their most productive years. However, all age groups are at risk. More than 95% of cases of illness and death occur in developing countries.

People with HIV infection are 18 times more likely to develop active TB (see the section on TB and HIV below). People with other health conditions that weaken the immune system are also at higher risk of developing active tuberculosis. People who are malnourished have a 3-fold increase in risk. In 2019, there were 2.2 million new cases of tuberculosis worldwide that were associated with malnutrition.

Alcohol use disorders and tobacco smoking increase the risk of tuberculosis by 3.3 and 1.6 times, respectively. In 2019, 0.72 million new cases of tuberculosis worldwide were attributable to alcohol use disorders and 0.70 million were due to smoking.

Global Impact of Tuberculosis

Tuberculosis is common worldwide. In 2019, the South-East Asia Region had the largest number of new cases of tuberculosis (44% of new cases), followed by the African Region (25%) and the Western Pacific Region (18%).

In 2019, 87% of new TB cases occurred in 30 high TB ​​burden countries. Two thirds of new tuberculosis cases occurred in eight countries – India, Indonesia, China, the Philippines, Pakistan, Nigeria, Bangladesh and South Africa.

Symptoms and Diagnosis

Common symptoms of active pulmonary tuberculosis are sometimes coughing up phlegm and blood, chest pain, weakness, weight loss, fever and night sweats.WHO recommends the use of rapid molecular diagnostic tests as the initial diagnostic test for all people with signs and symptoms of tuberculosis, as these tests have high diagnostic accuracy and will lead to significant improvements in the early detection of tuberculosis and drug-resistant tuberculosis. For rapid tests, WHO recommends Xpert MTB / RIF, Xpert Ultra and Truenat.

Diagnosis of multidrug-resistant tuberculosis and other resistant forms of tuberculosis (see(See section on multidrug-resistant tuberculosis below) as well as HIV-associated tuberculosis can be complex and costly.

It is especially difficult to diagnose tuberculosis in children.

Treatment

Tuberculosis can be treated and cured. For active drug-susceptible TB, a standard six-month course of treatment with four antimicrobials is given, with patient information and support from a health worker or trained volunteer.Without this support, it is more difficult to adhere to the treatment regimen.

An estimated 63 million lives have been saved since 2000 through the diagnosis and treatment of tuberculosis.

Tuberculosis and HIV infection

People with HIV infection are 18 (15-21) times more likely to develop active tuberculosis than those who are not infected with HIV.

HIV infection and tuberculosis are a deadly combination and accelerate each other’s progress.In 2019, approximately 208,000 people died of HIV-associated tuberculosis. In 2019, the proportion of registered TB patients with documented HIV test results was 69%, up from 64% in 2018. In the WHO African Region with the highest burden of HIV-associated TB, 86% of TB patients had documented HIV test result. Overall, in 2019, 88% of HIV-positive TB patients received ART.

WHO recommends a 12-component collaborative approach to tuberculosis and HIV to reduce mortality, including measures to prevent and treat infection and disease.

Multidrug-resistant tuberculosis

Anti-TB drugs have been in use for several decades, and strains resistant to one or more drugs have been reported in every surveyed country.Drug resistance arises from inappropriate use of anti-TB drugs, as a result of inappropriate prescriptions by health care workers, poor quality drugs, or premature discontinuation of treatment by patients.

Multidrug-resistant tuberculosis (MDR-TB) is a form of tuberculosis caused by bacteria that do not respond to isoniazid and rifampicin, the two most effective first-line anti-TB drugs. MDR-TB can be treated and cured with second-line drugs.However, these treatment options are limited and require extensive chemotherapy (up to two years) with expensive and toxic drugs.

In some cases, wider drug resistance may develop. Tuberculosis, caused by a bacterium that does not respond to the most effective second-line anti-TB drugs, can leave patients with no further treatment options.

In 2019, MDR-TB continued to be a crisis and health security threat.90,017 In 2019, a total of 206,030 people were identified and registered with multidrug-resistant TB or rifampicin-resistant TB (MDR / RR-TB), which is 10% more than in 2018 (186 883 person). About half of the global burden of MDR-TB is in 3 countries – China, India and the Russian Federation.

Currently, treatment success is achieved in only 57% of MDR-TB patients. In 2020, WHO recommended a new, accelerated (9-11 months) oral-only regimen for patients with MDR-TB.The study found that it is easier for patients to complete this treatment regimen compared to longer regimens lasting up to 20 months. Before starting treatment with this regimen, fluoroquinolone resistance should be excluded.

In accordance with WHO guidelines, detection of MDR / RR-TB requires bacteriological confirmation of tuberculosis and drug resistance testing using rapid molecular tests, culture methods or sequencing technologies.Its treatment requires a course of therapy with second-line drugs lasting at least 9 months and up to 20 months, accompanied by counseling and monitoring of side effects. WHO recommends expanding access to oral-only treatment regimens.

By the end of 2019, 89 countries had started using accelerated MDR-TB treatment regimens, and 109 countries had imported or started using bedaquiline to improve the effectiveness of MDR-TB treatment.

WHO Global Commitments and Action

Twenty-sixth September 2018The United Nations (UN) hosted the first-ever high-level meeting on tuberculosis, during which leaders of state and government discussed the status of the tuberculosis epidemic and how to end it. This meeting followed the first world ministerial conference on tuberculosis control organized by WHO and the Russian government in November 2017.The final document was a political declaration agreed by all UN member states, which reaffirmed existing commitments under the SDGs and the WHO Strategy on the elimination of tuberculosis and adopted new ones.

SDG Target 3.3 includes ending the tuberculosis epidemic by 2030. The End TB Strategy sets targets (2020 and 2025) and targets (2030 and 2035) to reduce tuberculosis incidence and mortality. The targets for 2030 are a 90% reduction in tuberculosis deaths and an 80% reduction in tuberculosis incidence rates (new cases per 100,000 population per year) from 2015 levels.are a decrease in mortality from tuberculosis by 35% and a decrease in the incidence of tuberculosis by 20%. The strategy also includes a 2020 benchmark to ensure that TB patients and their families do not incur catastrophic costs as a result of TB.

The UN High-level Meeting Political Declaration includes four new global targets:

• to provide treatment for 40 million people with tuberculosis over a 5-year period from 2018 to 2022; 90,021 90,016 over a 5-year period from 2018 to 2022.reach at least 30 million people with preventive treatment of latent tuberculosis infection;
• By 2022, commit at least $ 13 billion annually to ensure universal access to TB diagnosis, treatment and care;
• Allocate at least $ 2 billion annually for tuberculosis research.

In line with political declaration:

• In 2019, WHO developed and published a Multisectoral TB Accountability Framework.WHO is supporting countries to adapt and use the mechanism to deliver on their commitments, and to monitor, review and report on progress, with the participation of high-level decision makers, all relevant sectors, civil society and other stakeholders.
• In 2020, the UN Secretary-General presented to the General Assembly a progress report prepared and published with the support of WHO.
• Examples of high-level leadership in multisectoral accountability are presidential and head-of-state initiatives to end tuberculosis, formal stakeholder engagement and accountability mechanisms in India, Indonesia, Pakistan, the Philippines and Viet Nam, and national campaigns to accelerate progress, such as Race to End TB.

WHO is working closely with countries, partners and civil society to scale up TB action. WHO has six core functions that contribute to achieving the goals of the UN High-level Political Declaration, SDGs, Strategy to End TB and WHO’s Strategic Priorities:

• Providing global leadership for ending TB through policy development, political and multisectoral engagement, review and accountability, advocacy and partnerships, including with civil society.
• Shaping the research and innovation agenda and stimulating the generation, absorption and dissemination of knowledge.
• Setting norms and standards for the prevention and treatment of tuberculosis, and encouraging and encouraging their adherence.
• Develop and promote evidence-based ethical policy options for TB prevention and care.
• Provide specialized technical support to Member States and partners with WHO regional and country offices to accelerate change and build sustainable capacity.
• Monitor and report on the status of the tuberculosis epidemic and progress in funding and implementation at global, regional and country levels.

Postcoid syndrome: how it is expressed and how often it occurs: scinquisitor – LiveJournal

The SARS-CoV-2 coronavirus enters human cells, interacting with a target on their surface, which is called ACE2. The highest expression of ACE2 is observed in the epithelium of the small intestine, followed by the testes, kidneys, heart, thyroid gland, adipose tissue, salivary glands, vagina, mammary gland, pancreas, esophagus, ovaries, fallopian tubes, and only then only into the lungs [1 ].This suggests that the virus can penetrate into a wide variety of tissues and organs and cause damage. And scientists are just beginning to study the extent of this damage.
Indeed, it has been shown [2] that during the next six months of life after COVID-19 there is an increased risk of arrhythmias, chest pain, heart failure, tachycardia, hair loss, diabetes, constipation, fatigue, depression, muscle weakness, memory problems and sense of smell, as well as breathing disorders. Cognitive problems after coronavirus infection have been shown in separate studies [3].

All of this is called the postcoid syndrome. And recently there was a new article in JAMA Network Open that explored how often it occurs.

The authors analyzed 57 studies involving more than 250,000 people who have had COVID-19. The average age of patients was 54.4 years, 79% were hospitalized. More than half of those who have recovered experienced at least one long-term consequence of the coronavirus infection after six months. The most common problems were: breathing disorders, neurological disorders, mental health problems, and mobility disorders.One in four had trouble concentrating, one in three with anxiety disorder, as well as fatigue and muscle weakness.

When a virus enters our body, it begins to multiply and destroy our cells. In parallel, our immune system learns to recognize the virus. In this case, the cells of the immune system capable of neutralizing it multiply. It takes time for a reliable protection against the virus to appear, but during this time it can manage to break a lot in our body.Not just the lungs. The more viral particles you get initially, the more head start the virus will have. To give a head start, on the contrary, vaccination helps your body.

More people die from COVID-19 in a year than from HIV and tuberculosis combined. The mortality rate of infection is 2.2% (this is the ratio of deaths to those who have recovered), which is 20 times higher than that of influenza, although less than that of some other coronaviruses, such as the SARS virus or the Middle East respiratory syndrome virus (which, fortunately, are not so contagious ).

This is a virus that is best not to get sick. And if you are sick, then with the maximum handicap for your immune system. Get vaccinated. Russia has an effective vaccine Sputnik [5].

[1] Li, MY., Li, L., Zhang, Y. et al. Expression of the SARS-CoV-2 cell receptor gene ACE2 in a wide variety of human tissues. Infect Dis Poverty 9, 45 (2020).
[2] Al-Aly, Z., Xie, Y. & Bowe, B. High-dimensional characterization of post-acute sequelae of COVID-19. Nature 594, 259-264 (2021)
[3] Hampshire A, Trender W, Chamberlain SR, et al.Cognitive deficits in people who have recovered from COVID-19. EClinicalMedicine. 2021; 39: 101044
[4] Groff D, Sun A, Ssentongo AE, et al. Short-term and Long-term Rates of Postacute Sequelae of SARS-CoV-2 Infection: A Systematic Review. JAMA Netw Open. 2021; 4 (10): e2128568.
[5] Logunov, Denis Y et al. “Safety and efficacy of an rAd26 and rAd5 vector-based heterologous prime-boost COVID-19 vaccine: an interim analysis of a randomized controlled phase 3 trial in Russia.” Lancet (London, England) vol.397.10275 (2021): 671-681.

benefits and harms for women’s health

Pumpkin is the real queen of the autumn menu. In addition, this is a whole pharmacy, which contains medicines for many diseases, all doctors talk about the benefits of pumpkin. However, pumpkin can do both good and bad for our health. Let’s figure it out.

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Pumpkin is one of the oldest and favorite vegetables in our kitchen. Fruits in boiled or baked form are suitable for food, pumpkin seeds have long been known for their healing properties, in the Ukrainian culinary tradition there are even recipes for dishes from a baked pumpkin flower.

In the tale of Cinderella, the fairy godmother turns a pumpkin into a carriage – do you know why Charles Perrault used it in the text? Because back in the 17th century, this vegetable would have been guaranteed to be found in the kitchen in any, even the most poor house.

As you know, “everything is medicine and everything is poison” – this ancient saying also applies to pumpkin. It can bring both benefits and harm to the body – it is especially important to know about the rules for its use.

Nutritional value of pumpkin

The benefits of pumpkin: orange medicine

People began to find useful use of pumpkin a long time ago. Indeed, in terms of the content of nutrients and healing substances, the fruit surpasses many garden crops.

The pumpkin pulp contains the most important trace elements – potassium, calcium, magnesium, phosphorus. It also contains vitamins B1, B2, B12, PP. But pumpkin is especially rich in provitamin A – beta-carotene. This compound protects the body from the harmful effects of the environment, and cells from cancerous degeneration.

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In addition, pumpkin pulp contains a lot of pectins – dietary fiber that gently cleanses the intestines. Pumpkin is also useful for heart ailments, kidney and liver diseases, insomnia, hemorrhoids, atherosclerosis, colds, gout, nervous disorders, and vision problems. And in India, this fruit is used to treat tuberculosis.

Pumpkin is also useful for those who follow a vegan diet. 100 g of pumpkin contains 1 g of protein, so it contains much more protein than quail eggs.When combined with chickpeas, pumpkin becomes an indispensable source of protein for vegans and vegetarians.

Also pumpkin speeds up metabolism. If you have bad digestion, frequent bloating and constipation, be sure to eat pumpkin at least a couple of times a week.

What are the benefits of pumpkin for women

For women, raw pumpkin, including pumpkin juice, as well as baked pumpkin and its seeds, will be especially useful. With the help of pumpkin dishes, you can lose weight, lower cholesterol and remove heavy metal compounds from the body.

Pumpkin is also useful for the treatment of gynecological diseases. The pulp of a ripe vegetable helps with infertility, cervical erosion, female inflammation, vaginitis.

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Pumpkin is also useful for pregnant women – due to its high content of calcium, magnesium, iron, it will help prevent anemia. And during menopause, pumpkin dishes will help reduce the unpleasant symptoms of this period and relieve nervous tension.

Important! Ripe and healthy pumpkin should be firm, fleshy, heavy and firm, without cracks or dents.The variety of the vegetable is also important. Bright orange fruits are more suitable for making soups. And for cereals and pastries, it is better to take pink and yellow pumpkins.

Benefits of pumpkin for men’s health

Pumpkin perfectly helps to improve the condition of the male reproductive system. You can and should eat not only the pulp of a vegetable, but also seeds. Vitamin E-tocopherol helps to improve the quality of sperm, and pumpkin seeds contain a set of nutrients that improve testosterone synthesis and normalize erectile function.

Who should not eat pumpkin

Pumpkin should be excluded from the diet for such diseases:

• Diabetes mellitus
• Diseases of acute digestion
• Gastritis
• Duodenal ulcer
• Violations of acid-base balance in the body
• abuse raw pumpkin seeds during pregnancy: this can be fraught with premature birth. Pumpkin juice is harmful for digestive problems: it can cause nausea, bloating and diarrhea.Baked squash has a mild laxative effect and may cause diarrhea.

  Do not overuse pumpkin, as it can cause false carotene jaundice: you will have a pleasant yellowish color due to the abundance of carotene.

  In all other cases, pumpkin will bring undeniable health benefits.

  Pumpkin in medicine and dietetics

  Due to its beneficial properties, pumpkin is widely used in medicine and dietetics, in particular in dietetic nutrition.Some nutritionists recommend a pumpkin diet for weight loss. But watch out for : this is not about mono diets.