"Extremely Infectious"
Incubation Period Of Tuberculosis Health And Social Care Essay
Michael does not know exactly when he contracted tuberculosis, but he figures it must have been sometime during August 2007 in Bangkok. Before the beginning of his symptoms, he did not travel to any places that seemed especially prone to TB. He could have caught it anywhere, in a crowded disco, a bar, or even just sitting in a taxi with an infected driver. Tuberculosis is transmitted through the air when someone infected with TB coughs, sneezes, spits, laughs, or talks. By doing these things, they spread the TB germs in the air, and someone can catch them from breathing in the germs and exposing it to their lungs or mucous membrane.
The incubation period of tuberculosis is anywhere in-between two to twelve weeks. Therefore, the appearance of symptoms may not occur until months after the first exposure to the bacteria. There are many symptoms associated with tuberculosis, but they are not always a telltale sign of a disease as serious as this and are often mistaken for something much less severe. Some common symptoms of TB are a constant cough with mucus, coughing up blood, excessive night sweats, fatigue, fever, and unintentional weight loss. Some additional symptoms include difficulty breathing, chest pains, and wheezing. Michael's first sign that something was wrong was a case of the chills on a normal blistering hot day in the center of Bangkok. A few weeks later, he began to cough and feel a pain which he, at that time, thought was in his back. His condition rapidly became worse and worse, and two weeks after his cough first appeared, he went to visit a doctor at the leading international hospital in Bangkok. The doctor concluded it was just an infection and gave him some antibiotics. Of course, the antibiotics had no effect, and so he went back to see a lung specialist. The specialist concluded the same as the first doctor, but this time Michael insisted on an X-ray. The X-ray showed large clouded areas at the bottom of the lungs. Fluid around the lung, along with swollen or tender lymph nodes in the neck or other areas, and unusual breath sounds, are a few signs of tuberculosis. She told him that it was either lung cancer or tuberculosis, and she asked him to cough up some sputum, mucus like material from the lungs, so it could be analyzed. She also recommended him to get an HIV test because many people in Thailand have HIV before TB. Luckily, the HIV test came back negative, but that same day he was called back to the doctor's and officially told he had tuberculosis. A specialized hospital was to do a more in-depth analysis, but Michael was prescribed his treatment right away.
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As mentioned before, tuberculosis is highly infectious because of its ability to be transmitted through the air. The infectious period of this disease is hard to determine as a set amount of days or weeks or months. In theory, TB can be spread as long as the bacteria are actively being released from the infected person's sputum. However, the greatest chance of transmitting the infection is during the period before diagnosis. The risk of transmitting the infection is greatly reduced within days to two weeks after beginning treatment. This is why it is vitally important to get a quick diagnosis of TB and begin taking medication as soon as possible.
There are ways to prevent TB. The Bacille Calmette-Guérin (BCG) vaccination is effective for reducing TB meningitis and death in children, but it is only used in countries with high risk for TB for it is only effective for a short period of time. In fact, Michael had received this vaccination when he was born in Denmark, but he was told after he was diagnosed it was no longer effective. PPD skin tests are available in high risk populations and for people exposed to TB, such as doctors and nurses. A positive skin test shows contact with the bacteria, and prompt treatment is vital to prevent the spread of the bacteria from people with active TB to those never infected.
All countries are required to report information about tuberculosis surveillance to the World Health Organization. This data is used to form procedures to control the global spread of the disease. A person infected with TB should be isolated at home or a hospital for 2-4 weeks till they are not contagious anymore. TB is usually treated by a standard six month course of the four drugs isoniazid, rifampicin, pyrazinamide, and ethambutol. These medications must be taken as prescribed to prevent the bacteria from becoming resistant to the medications making it harder to treat. If the medications are not being taken correctly, patients may be sent to directly observed therapy where they are observed taking their medicine two to three times a week.
Michael's coughing rapidly decreased after being put on the medications, and his back/lung pain vanished after having the liquid in his lungs removed. Remembering to take his medicines several times throughout the day, without ever skipping, was a challenge, but he was determined. He was well informed by his doctors about side effects and different things he could not do. He experienced having almost red urine and remembered no alcohol was allowed during the six month treatment. Even though he knew nothing about tuberculosis before his diagnosis, he listened to his doctors and was smart enough not to stop taking his medicine after the first few weeks when his symptoms went away. He knew how important it was to stay on them regularly, and the six month treatment was a success. TB has the greatest chance of returning in the two years after a successful treatment, and so today, he is taking better care of himself, making sure to keep his immune system strong. He stays strong mentally and physically, and he is convinced he's beat tuberculosis once and for all.
Tuberculosis is a treatable disease, but certain circumstances can make treatment a more lengthy, expensive, and risky venture. Suren Arakelyan is a forty four year old man currently residing in an Abovyan hospital on the outskirts of Yerevan the capital of Armenia, his native home. He has been battling TB for fifteen years since contracting it after a short stay in a Russian prison for a brawl in St. Petersburg. Patchy antibiotics defeated the disease once, but it returned in 2008 in the form XDR-TB, extensively drug-resistant tuberculosis. XDR-TB is one form of drug-resistant tuberculosis. Drug-resistant tuberculosis is when the bacteria become resistant to the drugs usually used to treat TB. This can happen when prescribed the wrong treatment, dose, and/or length of time, when the drugs are unavailable or of bad quality, when people do not take all of their TB medications or take them regularly, when they develop TB for a second time, or when they are infected by someone with drug-resistant TB. Multi-drug resistant tuberculosis (MDR-TB) is when the bacteria is resistant to at least isoniazid and rifampin, the most often used and effective TB medications. Extensively drug-resistant tuberculosis a rare type of MDR-TB that is resistant to isoniazid and rifampin, fluoroquinolone, and a minimum of one of the three injectable second-line drugs (such as amikacin, kanamycin, or capreomycin). XDR-TB is resistant to the strongest first-line and second-line TB drugs, and therefore treatment of this strain is less effective, more expensive, and prone to more side effects. Drug-resistant tuberculosis may need up to two years of chemotherapy depending on how many drugs the bacteria are resistant to.
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Arakelyan is emaciated and despondent, and he has lost half his lung tissue from the disease and much of his hearing due to the toxic drugs. He is lonely and separated from his family, a wife and young children, who live in distant Belarus. Hopeless, he skips and refuses some of his prescribed medications, the side effects on his body too difficult to bear, but this only worsens his situation and strengthens the bacteria's resistance. Taking all of the medications exactly as they were prescribed and never missing or stopping treatment early are the best ways to prevent drug-resistant tuberculosis. Being quickly diagnosed and starting treatment immediately and limiting exposure to those infected with drug-resistant TB will also help prevent MDR-TB or XDR-TB.
Scientists continually conduct research to find better treatments for TB. Scientists at Yeshiva University in Bronx, NY are researching how TB infects/causes disease in humans, how the human immune system responds, and identifying the factors that allow the survival and reproduction of the bacteria in the host. They are also studying the mechanisms of drug resistance and how M. tuberculosis is able to survive long-term drug treatments to determine more effective drugs and methods of treatment against TB. They work towards creating new powerful vaccines to better prevent and protect against all strains of TB. Scientists at the University of Illinois in Chicago work to optimize anti-TB drugs to kill the bacteria while being less toxic/non-toxic to human cells. They are also studying the use of natural products against TB and developing tools to help better the discovery of new drugs.
Tuberculosis wasn't once called consumption and the wasting disease for nothing. Without proper treatment, TB can be life threatening and if not can still make life difficult and miserable. Precautions should always be taken in high risk areas until the day when scientists discover a definite cure.
