Tuberculosis
fever; sweat; TB; tuberculosis; lung; infectious diseases; immunisation; immunise; vaccine; vaccination; BCG; mantoux ;
Contents
Tuberculosis is one if the oldest diseases known. It is very common in areas of the world where there are crowded cities and poor living conditions. Tuberculosis is now rare in Australia.
What is tuberculosis?
- Tuberculosis is an infection caused by a bacterial organism (mycobacterium tuberculosis).
- The initial infection (primary infection) usually does not cause any symptoms, and usually the only sign of it is a positive reaction to a skin test (Mantoux test).
- Some time after the first infection (usually in the first 2 years, but it can be many years later) the infection may become active and cause disease. Only about 10% of people with the primary infection go on to have any health problems from TB. It is more common for children to have health problems than adults.
- Usually the disease of tuberculosis is in the lungs, but it can affect other parts of the body (eg bones, kidney and lymph glands). It can also be wide spread throughout the body (called miliary tuberculosis).
- The rate of TB in Australia is amongst the lowest in the world. About 1000 cases of tuberculosis are reported in Australia each year (about 5-6 per 100,000 Australians). In Australian born people the rate is lower, about 2 per 100,000, but there are higher rates in the high risk groups.
Who is most at risk?
- Aboriginal and Torres Strait islander people, some young immigrants from high risk countries (especially those who have lived in refugee camps), homeless persons, close contacts of people who have TB and health care workers are at higher risk of being exposed to and infected by tuberculosis.
- People who have weakened immune systems (eg due to illnesses such as HIV/AIDS, or who have poor living conditions), infants and elderly people are at most risk of developing health problems if they are infected.
- It has been estimated that a third of the world's population has been infected with TB and several million die from TB each year.
- The numbers who are infected is growing because of increasing world population, poverty, inadequate nutrition and lack of access to effective treatment.
Signs and symptoms
- The primary infection usually does not cause any symptoms, but in a small number of cases it can cause a mild illness. After several weeks the person would react to the skin test (Mantoux Test).
- If disease occurs it is usually in the lungs, causing a cough (which may eventually produce blood stained sputum (spit)), fever, sweating, tiredness and weight loss.
- The symptoms of the disease in other areas of the body depend on what is affected.
Spread of infection
- When a person has active tuberculosis in the lung, infection can be spread or passed to another person through coughing, sneezing or speaking. Infections in other parts of the body are usually not infectious.
- The person can spread the disease until he has begun an adequate course of treatment (usually after about two weeks of the treatment).
- People found to have tuberculosis should be excluded from school, preschool, child care or work until treatment has begun and a medical certificate is provided by the appropriate health authority.
The incubation period is the time between becoming infected and developing symptoms.
Symptoms, if they occur, are present about 4 to 12 weeks after the lung infection.
Prevention of tuberculosis
- Because there is not a lot of tuberculosis in Australia, immunisation (BCG) is not used in the general population and would have very little impact on controlling TB.
- In Australia BCG is recommended for:
- Aboriginal and Torres Strait babies who are born in areas of high risk of tuberculosis
- babies and young children in households where there are immigrants from areas of high risk, or where the people who live there have recently visited places where there is a high risk of TB
- babies born to mothers who have leprosy (BCG is also very effective in protecting against leprosy)
- babies and young children who travel to live in areas of high risk for long periods, particularly as multi-drug-resistance is becoming more common in those countries (see the World Health Organisation site www.who.int/gtb/country-info/index.htm )
- children and young people who continue to be around people with active untreated tuberculosis, and who cannot take prevention treatment or where the exposure is to drug-resistant disease
- some health care workers
- some travellers over 5 who will be spending a lot of time in countries with high risk.
- People who think that they or their children have been in contact with tuberculosis should consult a doctor (or specialist chest disease unit) to check whether they have been infected and whether they need treatment. In South Australia, contact the Chest Clinic at the Royal Adelaide Hospital.
- Mass X-ray screening for tuberculosis is no-longer considered necessary for the general population in Australia and is limited to high risk groups such as people coming to Australia from high risk countries and people who have been in close contact with someone who is infectious.
Treatment
- People with tuberculosis are usually given 4 antibiotics for the first two months and then four months (a total of at least 6 months of treatment).
- Some tuberculosis bacteria have become resistant to the usual antibiotics and are becoming difficult to treat (drug resistant). This can be because of patients not following the directions properly or inadequate treatment being prescribed.
Resources
South Australia
SA Tuberculosis Services is located within the Chest Clinic at the Royal Adelaide Hospital. The clinic conducts screening for infection in high risk groups and provides management of people with active disease.
For more information call 8222 5307 or 8222 5483 or visit the Chest Clinic during business hours at275 North Terrace Adelaide SA 5000.
www.rah.sa.gov.au/internal/thoracic.htm
References
Australian Immunisation Handbook 9th edition 2008.
http://immunise.health.gov.au/
Department of Health (South Australia) Tuberculosis (TB).
http://www.dh.sa.gov.au/pehs/ygw/tuberculosis-pehs-sahealth-2009.pdf
The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Parent Helpline on 1300 364 100 (local call cost from anywhere in South Australia).
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