Tuberculosis (often called TB) is a disease caused by a germ called Mycobacterium tuberculosis. It most commonly affects the lungs, and is caught from other people.
The body’s immune system usually destroys the germs once they are inhaled, but they may cause an illness weeks or even months later.
Sometimes TB causes no immediate illness, but remains dormant in the body before developing many years later. This is more likely if the body is weakened by other medical problems. People most at risk are those with damaged immune systems.
Youngsters from high risk groups, whose parents were born abroad, will be offered a vaccination against TB called the BCG. The BCG vaccination does not give complete protection against TB, but does help the body’s defences fight it off. The vaccination lasts at least 15 years and you can only have it once.
What are the symptoms?
TB can affect any part of the body, but most commonly affects the lungs or lymph glands. The most common symptom is a cough, sometimes accompanied by sputum (phlegm) which can be bloodstained. There may also be chest pain, weight and appetite loss and a fever with sweating, particularly at night.
When TB affects the lymph glands, these may appear as lumps on the neck. TB is usually diagnosed after a chest X-ray has been taken and a specimen of phlegm examined.
Can I infect other people?
You can pass TB onto others if you have lots of TB germs in your phlegm. Doctors sometimes call this ‘open TB’ or say you are ‘sputum positive’. You can help prevent the spread of infection by covering your mouth when you cough and then washing your hands. Make sure you dispose of any tissues you use carefully.
You very soon stop being infectious after starting treatment and after two weeks there is no risk to other people.
There is no infection risk to others when TB germs cannot be seen in the sputum, or when TB affects the lymph glands or other parts of the body.
People in the same household as you, and in some cases work colleagues, will be offered a check-up, but only rarely are they found to be ill with TB. Most people having a check-up will have a chest X-ray and children and younger teenagers will have a simple skin test.
If the test is negative, they have not been infected and will be offered a BCG vaccination. If the test is positive, it means either they have had BCG in the past or have been infected with TB at some stage.
Very often no treatment is necessary, but the individual will continue to have check-ups.
Occasionally, a simpler course of anti-TB medication is given to people who appear entirely well but are at increased risk of becoming ill with TB in the future.
TB can be completely cured by treatment with a course of tablets. The tablets must be taken daily, or three times weekly, for six to nine months.
Many people have all their treatment at home, but others may be admitted to hospital for the first week or so. This is more likely if they are very ill at the time of diagnosis or they are thought to be highly infectious to other people.
When somebody is being treated at home for TB there is no need for special measures, such as separate dishes or cutlery.
Special diets are not required but eating well helps recovery. Most people find that their appetite improves once they start taking their tablets.
- Never miss taking your tablets. If you forget them in the morning, take them later in the day.
- Don’t let yourself run out of tablets – get a new supply before they are finished.
- If you are worried about your symptoms or your treatment, speak to your doctor/nurse.
- TB can be cured completely but only if you take your tablets regularly and for the whole course. Do not stop because you are feeling well again. Only stop when your doctor tells you it is safe to do so. TB can become resistant to treatment if you stop taking your drugs.
Are there side-effects?
- One of the tablets commonly used to treat TB discolours urine and gives it an orange-red colour.
- Soft contact lenses may also be permanently discoloured.
- Tablets used to treat TB do not usually cause any problems, but if you develop jaundice (yellowness around the eyes and on the skin), a rash, feeling of sickness, itchiness, giddiness, difficulty in seeing or experience pins and needles, consult your doctor at once. If one of your tablets is upsetting you, your treatment can be changed, but it must not be stopped completely until you are fully cured.
- Some tablets used in TB treatment contain a drug which makes the oral contraceptive pill less effective. If you are taking the pill, ask your doctor about other methods of contraception while you are on TB treatment.
Returning to work
This should be discussed with the specialist in charge of your treatment and your GP. Sometimes the TB is so mild that the individual is never off work. Others may need to stay off work until they are no longer infectious or until they feel strong enough to return to full activity.
If your tablets are taken regularly, you can expect a full recovery. Make sure you let your employers know about this.
How long will my treatment last?
You will have to visit the hospital clinic until your treatment is finished and perhaps even a little longer. This will take six to nine months. Most people only have to attend the clinic once every three to four weeks at first, then less frequently after that. Some clinics will continue to see you once or twice a year for two years after you complete the treatment.