Wednesday, 4 November 2020

Latent Tuberculosis

 

What gynaecologits should remember about Kochs:-

Q.1: How many members are aware that o yoyDo  about one-third of the world’s population is infected with this type of bacteria? But those who acquire infection not all of them don’t develop active Koch’s due to his/ her potent immune system either self developed or developed out of BCG vaccination.

 

Q.2: Out of all people infected with Kochs bacilli how many will get infected and why do Pulmologist or health workers working at Chest OPD/Chest indoor :

a)  Only around 10–20 percent of people with this infection develop “active TB.” and b) Health workers develop some defensive immune system due to chr exposure .This bacteria is also like COVD-19 virus in the sense that many  develop seroconversion without having symptoms of fever, cough, loss of smell , profound weakness. But only few people get active symptomatic TB .. est who get exposed to bact are become latent koch’s. In many advanced a countries majority  of population have never been infected with such  bacilli as in  US. This is, however  in contrast to our country.

Q.3:-What are the symp of active TB?? Ans: Symptoms of TB include a bad cough, chest pain, and breathlessness. Symptoms of TB can develop slowly and may vary. The main symptoms of pulmonary TB include:

  • a bad cough that lasts for at least 3 weeks
  • chest pain
  • coughing up blood or phlegm from the lungs
  • breathlessness

More general symptoms of TB can include:

  • weight loss
  • a loss of appetite
  • nausea and vomiting
  • low energy or fatigue
  • fever and chills
  • night sweats

Q. 4:-What are the symp of active TB?? People with latent TB do not have any symptoms or feel sick.

Q,5: What is the etiopathology??

TB is an infection caused by a type of bacteria called Mycobacterium tuberculosis (M. tuberculosis).

Q.6: What is latent Kochs infection?? Ans:-A person who carries the bacteria but does not develop symptoms are termed as “latent TB.” Q.7:  Is latent TB contagious?? Ans: No .  This is not contagious, but it can eventually develop into active TB, particularly if a person’s immune system becomes weakened from a condition such as HIV/ Malignancy/ severe malnutrition in famine etc .

Q.8: It is a bacterial disease. As such Nature’s rule will be applied. There is strong correlation of host immune mechanism and reactivation of many diseases like TB/Toxo/ Herpes / CMV:--For instance, in a latent case àTB can become active when the immune system is unable to prevent the bacteria from multiplying.  But fortunately most people with latent TB never go on to develop active disease. One can use a skin or blood test to check for the presence of M. tuberculosis in her/his body. A HCP(Health Care Provider) can determine whether a person is infected with TB bacteria using a skin or blood test. The skin test involves a healthcare provider injecting a small amount of fluid called tuberculin into the person’s lower arm. The test is positive if the skin develops a bump or swelling within 48–72 hours of the injection.

The blood test involves taking a small sample of blood and analyzing it for an immune system response to the TB bacteria.(discussed today morning)

 

Q.9: Mode of transmission: People with active pulmonary TB exhale the bacteria in tiny water droplets when they cough, sneeze, or speak. These droplets travel through the air and a person can breathe them in. This happens in case of COVID too.

Q.10:-Why office colleagues/ class mates are usually remain unaffected from colleague??  Ans: An individual generally needs to be in prolonged close contact with someone who has active TB to contract the infection. A TB infection in a part of the body other than the lungs is not usually contagious(abdominal/ Lymph nodes/Bone TB) .

Q.11: What about Vaccine ?? A vaccine called bacillus Calmette-Guérin (BCG) is available, but it is not in wide use in the United States, where TB rates are low. However, doctors of the respective country may recommend the vaccine for children or healthcare workers who have a high risk of TB exposure.

Q.12 What will be Treatment modality ?

Treatment depends on whether a person has active or latent TB.For people with latent TB, it is recommend  to offer preventive therapy is recommended    which typically involves taking isoniazid daily for 6–9 months. But , people with active TB usually need to take a combination of antibiotics for 6–12 months. First-line treatment options include isoniazid, rifampicin, ethambutol, and pyrazinamide. While some people with active TB require a short hospital stay, and many can receive treatment at home. We should counsel the family members that most people start feeling better and are no longer able to pass on the infection after a few weeks of treatment. However, it is essential to complete the full course of treatment exactly as per instruction of the Rule of the Land / concerned Pulmologist to keep the disease from recurring and to prevent the bacteria from becoming resistant to the drugs.

 Q.12 What is most danger ahead?? Ans It is the development strain of MDR Kochs. Drug-resistant TB is much more difficult to treat and can be very dangerous if a person passes such highly virulent bact to other people. TB is curable, but it can be life-threatening if a person does not receive the right treatment. Also, latent TB can progress to active TB if a person does not receive preventive treatment.

If a person tests positive for the bacteria, the doctor may also order a chest X-ray or sputum test to determine whether the infection has progressed to active disease.

Anyone with symptoms of TB should see  a HCP . Also, anyone who believes that they may have been in close contact with a person who has active TB should seek medical advice. However, the CDC report that the incidence of TB in the U.S. has been steadily declining since 1993. The incidence of TB in 2018 was 2.8 cases per 100,000 persons, which is the lowest ever to be reported in the country.

In 2016, doctors attributed 528 deaths to TB in the U.S., an increase from the 470 deaths reported in 2015.

Carry home message:--The CDC estimate that up to 13 million people in the U.S. may have latent TB and that around 1 in 10 of these individuals will develop active TB. The risk of latent TB progressing to active TB is greater among people with weakened immune systems, including those who have HIV or who are receiving immunosuppressive therapy, such as for cancer or an organ transplant.It is crucial that people seek medical attention if they experience symptoms of TB or have had contact with anyone who has active TB. The disease is highly treatable, especially when a person receives an early diagnosis.

Summary

TB is one of the world’s deadliest diseases, with approximately 1.3 million related deaths occurring worldwide in 2017. TB is also a leading cause of death among people who have HIV.

Pulmonary TB is a bacterial infection of the lungs that can cause a range of symptoms, including chest pain, breathlessness, and severe coughing. Pulmonary TB can be life-threatening if a person does not receive treatment.

People with active TB can spread the bacteria through the air. However, a person usually needs to be in prolonged close contact to become infected.

Most individuals who become infected with TB bacteria do not feel sick or experience any symptoms. Doctors describe this as having latent TB. Latent TB is not contagious but it can eventually develop into active TB.

Doctors treat latent or active TB with a long course of antibiotics. People with active TB usually begin to feel better after a few weeks of treatment.

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