Tuberculosis as the world’s most dangerous infectious disease

In 2015, 1.8 million people died as a result of tuberculosis. Consumption, as the dangerous infectious disease is also popularly known, is transmitted via bacteria. Alarmingly, many strains of bacteria are resistant to antibiotics. The figures from the World Health Organization (WHO) are frightening: about every 20 seconds, someone dies from tuberculosis (Tb or Tbc). A tuberculosis patient can infect up to 15 people a year. A third of the world’s population is considered infected. Between 4,000 and 6,000 new cases are reported in Germany every year.

Tuberculosis – a defeated disease?

For many years, it was believed that tuberculosis, like the plague and leprosy, had been conquered thanks to modern medicines, better health care and hygiene. This is the case for Western industrialized countries. But the immune deficiency 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 a significant medical problem. The fact that bacterial strains that are resistant to most antibiotics and classic tuberculosis drugs are spreading is particularly dramatic for those who are ill. Such a strain – the technical term multidrug-resistant tuberculosis (MDR-TB) – has now been detected in over 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 arises from the fact that not all bacteria are killed during therapy. That is why combinations of drugs are used in tuberculosis treatment to destroy as many germs as possible. In addition, the application must be long enough. If patients only take the medication irregularly or stop 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 almost always transmitted by tubercle bacteria via droplet infection. The pathogens are inhaled and enter the lungs. Here, the scavenger cells (macrophages) attack the bacteria, but most bacteria survive thanks to a unique protective mechanism.

When the scavenger cell disintegrates after the work, the bacteria can become active again, and new macrophages are needed. This is how the first focus of inflammation develops, the so-called primary tuberculosis.

 

Tuberculosis: course and symptoms

The body often protects itself by encapsulating the focus of inflammation – the pathogens do not spread further. The infected person feels no discomfort. But often enough – sometimes after years – and favoured by a weakened immune system– tuberculosis pathogens enter 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, nocturnal moderate fever attacks, and weight loss are symptoms that can also point to other infectious diseases. After weeks of coughing with bloody sputum and severe physical weakness (hence the name consumption ), the symptoms are more prominent.

Detection of tuberculosis

Definite proof is only possible with a clinical-chemical analysis of bronchial secretion, for example.

There is also the tuberculin test: a substance obtained from the capsules of the tuberculosis bacteria is injected into the skin using a stamp; a skin reaction (usually a palpable nodule) after 72 hours at the earliest indicates an infection, even if it is not open tuberculosis.

Open tuberculosis is notifiable.

Tuberculosis is contagious when a focus of inflammation breaks open because pathogens can now escape to the outside. This dreaded open tuberculosis must be reported to the health department immediately. The patients are isolated because the risk of infection is very high.

The incubation period is between four and six weeks.

 

treatment of tuberculosis

Infectious diseases are curable if patients are treated promptly and consistently with appropriate medication. Tuberculosis is treated with antibiotics, which must be administered for around nine months. The patient must be examined regularly for two years.

Vaccination against tuberculosis

Surviving tuberculosis does not protect against a new infection. Vaccination, therefore, only makes sense for certain people, such as medical staff or small children and older people who are exposed to a higher risk of infection, for example, from infected relatives.

Specific immune cells are activated during vaccination, ultimately reducing the infection risk. However, according to tests by the WHO, numerous vaccinated people experienced a general deterioration in the body’s defences, 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 bacteriological department of the Imperial Health Office in Berlin, in his lecture “Etiology of Tuberculosis” on the discovery of the tubercle bacterium. A few years later, Koch developed a vaccine against tuberculosis.

Because of his merits, the disease is also called “Morbus Koch”.