In 2015, 1.8 million people died as a result of tuberculosis. Consumption, as the so dangerous infectious disease is also called in the vernacular, is transmitted via bacteria. Alarmingly, many strains of bacteria are resistant to antibiotics. The figures of the World Health Organization (WHO) are alarming: about every 20 seconds a person dies of tuberculosis (TB or also Tbc). A tuberculosis patient can infect up to 15 people a year. One-third of the world’s population is considered infected. Between 4,000 and 6,000 new cases are reported annually in Germany.
Tuberculosis – a defeated disease?
For many years, it was believed that tuberculosis, like plague and leprosy, had been defeated thanks to modern medicines, better health care and hygiene. For Western industrialized countries, this was largely true. However, the immunodeficiency disease AIDS and the greater mobility of people through travel or immigration is one reason for the return of tuberculosis.
Spread of resistance
In Africa, Eastern Europe, and Central Asia, the disease has become one of the major medical problems. Particularly dramatic for sufferers is the fact that bacterial strains resistant to most antibiotics and classic tuberculosis drugs are increasingly spreading. Such a strain – technical term multidrug-resistant tuberculosis (MDR-Tb) – has now been detected in more than 100 countries, including Western Europe and North America. Such strains develop when patients discontinue treatment prematurely, which is predominantly the case in the world’s poorer countries. Resistance is caused by the fact that not all bacteria are killed during therapy. For this reason, combinations of drugs are used in tuberculosis treatment in order to destroy as many germs as possible. In addition, the application must be long enough. If patients take the drugs only irregularly or discontinue treatment, there is a risk that the disease will flare up again – this time with resistant germs.
Transmission by droplet infection
Tuberculosis is a chronic infectious disease that is almost always transmitted by tubercle bacilli via droplet infection. The pathogens are inhaled, enter the lungs. Here the scavenger cells (macrophages) attack the bacteria, but thanks to a special protective mechanism, most of the bacteria survive. When the scavenger cell disintegrates after its work is done, the bacteria can become active again, and new macrophages must be produced. Thus, an initial focus of inflammation is formed, the so-called primary tuberculosis.
Tuberculosis: Course and symptoms
Often the body protects itself by encapsulating the focus of inflammation – the pathogens do not spread further. The infected person experiences no symptoms. But often enough – sometimes after years – and favored by a weakened immune system, the pathogens of tuberculosis find their way into the body. Inflammatory foci develop again, not only in the lungs, but also in the kidneys, bones or brain. The insidious thing about tuberculosis is its insidious course: Coughing, nightly moderate fever attacks and weight loss are symptoms that can also point to other infectious diseases. With weeks of coughing with bloody sputum and severe physical weakness (hence the name consumption), the symptoms are already more obvious.
Detection of tuberculosis
Clear detection is only possible by clinical chemical analysis, for example of bronchial secretions. In addition, there is the tuberculin test: a substance obtained from the capsules of the tuberculosis bacteria is injected into the skin via a stamp; a skin reaction (usually a palpable nodule) at the earliest after 72 hours indicates an infection, even if it is not overt tuberculosis.
Open tuberculosis is reportable
Tuberculosis is contagious when a focus of inflammation breaks open, because the pathogens now reach the outside. This is the dreaded open tuberculosis, which must be reported immediately to the health department. Patients are isolated because the risk of infection is very high. The incubation period is between four and six weeks.
Treatment of tuberculosis
The infectious disease is curable if patients are treated promptly and consistently with appropriate medications. Tuberculosis is treated with a combination of different antibiotics, which must be administered for approximately nine months.The patient must be examined regularly for two years.
Vaccination against tuberculosis
Having survived tuberculosis does not protect against a new infection. Therefore, vaccination is only useful for certain people, such as medical caregivers or young children and elderly people who are at higher risk of infection, for example, through infected relatives. Vaccination activates certain immune cells, which ultimately reduces the risk of infection. However, according to WHO trials, numerous vaccinated individuals experienced a general deterioration of the body’s defenses, including complications such as abscesses at the vaccination site, bone and bone marrow inflammation, and meningitis.
Discovery of tuberculosis
On March 24, 1882, Dr. Robert Koch, head of the bacteriology department of the Imperial Health Office in Berlin, reported the discovery of the tubercle bacterium in his lecture “Etiology of Tuberculosis.” A few years later, Koch developed a vaccine against tuberculosis. Due to his merits, the disease is also called “Koch’s disease.”