Pulmonary Tuberculosis: Symptoms, Treatments, Outlook, and More



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Tuberculosis-Infectious Woman Refuses To Get Treatment And Isolate, Putting Public At Risk

A women in Tacoma, Washington, who has tuberculosis (TB), has been refusing treatment and was ... [+] spotted taking public transit and going to a casino. (Photo: Getty)

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When you have a contagious disease like tuberculosis (TB), refusing treatment and refusing to isolate are not personal choices. Such choices affect not only you but also everyone around you, at least those with nostrils or mouths. That's why there is now a warrant for the arrest of a woman in Tacoma, Washington, as reported by KOMO News. She has TB yet for over a year now has refused to be treated or to be isolated. That's two not-to-be's that be bad for preventing the spread of TB. Although Pierce County judge Philip Sorenson signed off on that arrest warrant last month, that TB move doesn't appear to be having much effect as the woman was recently spotted taking public transit and going to a casino.

This has been an "If at first you don't succeed, try, try again fifteen times" situation. So far, there have been 16 court orders for this woman to submit to the Tacoma-Pierce County Health Department (TPCHD) for involuntary detention, testing, and treatment. This has meant that a whole lot of taxpayer money has gone into getting one person to take steps to protect not only her own health but also the health of those around her. This would mean taking a medication called isoniazid (INH) in combination with three other drugs: rifampin, pyrazinamide and ethambutol. While treatment would last three to nine months, she would have to stay isolated no longer than 45 days or until testing has shown that she is no longer contagious.

TB can result when you breathe in Mycobacterium tuberculosis bacteria that's exhaled by someone who is infected. So if you are infected, you can spread Mycobacterium tuberculosis into the air by coughing, speaking, or singing the Doors song, "Break on Through to the Other Side" or any song for that matter. When you air such infectious grievances, they can hang in the air for others to breath into their lungs. This is why those with active TB are often kept in negative pressure rooms. In this case, negative pressure doesn't mean being in a room with someone who is telling you to do something because you suck. Instead, it's a room where the air pressure inside is lower than the air pressure outside the room. As a result, whenever the door is opened, this pressure difference effectively sucks air into the room so that any dangerous airborne pathogens don't leave the room.

This chest X-ray shows pulmonary tuberculosis, interstitial infiltration in the left upper lung due ... [+] to Mycobacterium Tuberculosis infection (Photo: Getty)

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Getting TB is not to be a fun thing. The infection can ravage your lungs as well as other parts of your body such as your kidneys, spine, and brain. Typical symptoms include a chronic cough, coughing up sputum or blood, and chest pain. You may become weak and fatigued, suffer fever, chills, and night sweats, and lose your appetite and weight. You may have any combination of these symptoms. Of course, these symptoms aren't always specific to TB. For example, just because you lose your appetite after watching that vomiting scene in the 2011 movie Bridesmaids doesn't necessarily mean that you have TB.

You can be infected with Mycobacterium tuberculosis without having symptoms. This is called latent TB. When you have latent TB, you aren't infectious. However, you should still get treatment because latent TB could always become active TB.

Now, TB treatment is not like eating a hot dog. Once you start, you had better finish the entire course. Ending treatment early could end up selecting for and promoting Mycobacterium tuberculosis that's resistant to antibiotics. Taking the full course of treatment makes it more likely that you will wipe out all the Mycobacterium tuberculosis in your body and not just the weaker ones.

Speaking of hot dogs, not too many people relish getting TB. It can be a killer, and not in a positive sense of the word. The World Health Organization (WHO) indicates that "A total of 1.6 million people died from TB in 2021," and that "Worldwide, TB is the 13th leading cause of death and the second leading infectious killer after COVID-19." While TB in its early stages is very treatable, those who go untreated may have a 50% probability of dying.

So it would totally make sense to get treated if you are infected with Mycobacterium tuberculosis. And it would totally make sense for others to want you to get treated if you are infected with Mycobacterium tuberculosis. After all, no one should say, "It would be great for there to be more TB."

As they say, it's all fun and games until someone gets TB. You can cry freedom all you want, but that doesn't mean that you have the freedom to put others in danger.


Pediatric TB May Affect Lung Functioning, Growth Later In Life

FOR IMMEDIATE RELEASE

Contact:

Jillian McKoy, jpmckoy@bu.Edu

Michael Saunders, msaunder@bu.Edu

##

Pediatric TB May Affect Lung Functioning, Growth Later in Life

A new study shows that young children diagnosed with pulmonary tuberculosis are at an increased risk of subsequent wheezing, poor lung function, and reduced height and weight later in their childhood.

More than one million children develop tuberculosis globally each year, and TB remains among the top 10 causes of pediatric mortality. While there are treatments for children who develop pulmonary TB (PTB), no studies have examined the long-term impact of this disease on children's health after they recover from infection.

Now, a new study led by a School of Public Health researcher has found that children who develop PTB are at an increased risk for health complications later in their childhood.

Published in the American Journal of Respiratory and Critical Care Medicine, the study showed that children aged 5 years or younger who developed PTB were more likely to subsequently wheeze and have poor lung function and reduced height and weight for their age, even after accounting for preexisting respiratory and growth conditions.

As the World Health Organization calls for increased investments and accelerated global action to end TB, these latest findings underscore the importance of prevention of TB in young children to avoid potential long-term health complications as they grow older. The study is the first to show post-TB pediatric growth impairment and an association between PTB and wheezing or recurrent wheezing after the infection.

"Although there is an effective treatment for tuberculosis in children, there is concern that the impact of tuberculosis may be long-lasting and there could be long-term morbidity even after treatment and recovery," says study lead and corresponding author Leonardo Martinez, assistant professor of epidemiology. "These results suggest that prevention of tuberculosis disease in the first few years of life may have substantial long-term health benefits, in particular to lung health, through childhood."

For the study, Martinez and colleagues from the Red Cross War Memorial Children's Hospital in Cape Town, South Africa, the University of Cape Town, and the University of Western Australia followed a cohort of 1,068 children from birth up to nine years old in two communities outside of Cape Town, from March 2012 to March 2015.

Study senior author Heather Zar, chair of the Department of Paediatrics and Child Health at the University of Cape Town, says the study leverages a unique opportunity to observe children who were enrolled in the South African Drakenstein Child Health Study, a birth cohort study.

"Given the large burden of childhood TB in low and middle income countries, these results are crucial in delineating the burden and morbidity associated with TB illness, and in strengthening preventive interventions," Zar says.

Child growth during the early years of life is critical to avoid stunting and permanent neurodevelopment issues. Children in the study who developed TB before one year of age had a lower weight and BMI for their age by the time they turned five years old, and those who developed PTB between one and four years of age had a lower length for their age.

The researchers found that children who developed PTB were at a greater risk of post-TB wheezing, regardless of when they developed the infection. Children who developed PTB before they were six months old had more than double the risk of wheezing after 6 months, compared to children who did not develop PTB. The risk of subsequent wheezing also increased when children developed PTB before they were 12 months, 24 months, or 36 months old.

The team also found that PTB was associated with lung function impairments that persisted for years after the acute infection and illness.

"By leveraging the unique opportunity of this South African birth cohort study, this study is the first to show that early life TB disease has substantial long term consequences on child health including growth, wheezing and lung function, independent of any underlying impairment. Given the large burden of childhood TB in low and middle income countries, these results are crucial in delineating the burden and morbidity associated with TB illness, and in strengthening preventive interventions."

In order to reduce TB rates, several developments are crucial to ensuring children receive adequate preventative care, Martinez says—such as new vaccines, increased screening for at-risk children, and increased access to current treatments.

"Most children in high-burden settings are not identified by health services before they progress to tuberculosis disease," he says. "They are found typically because they have presented with TB symptoms and then need to be diagnosed and treated. Identifying children that are likely to develop TB in the future is critical but, at the moment, difficult." Preventive treatment regimens are costly and lengthy, and therefore difficult for many children to complete, he adds.

"But I am very hopeful for the future of tuberculosis control and, in particular, the control of the pediatric tuberculosis epidemic," Martinez says. "There is huge momentum in the field to work together to find new scientific discoveries that are directly relevant to those at risk of or whom have the disease. There is also a large push for a patient-centered approach that includes and listens to survivors of the disease. These and other developments make me hopeful for the direction of our field and the control of tuberculosis in the future."

**

About Boston University School of Public Health

Founded in 1976, Boston University School of Public Health is one of the top five ranked private schools of public health in the world. It offers master's- and doctoral-level education in public health. The faculty in six departments conduct policy-changing public health research around the world, with the mission of improving the health of populations—especially the disadvantaged, underserved, and vulnerable—locally and globally.

Journal

American Journal of Respiratory and Critical Care Medicine

Method of Research

Observational study

Subject of Research

People

Article Title

The Long-Term Impact of Early-Life Tuberculosis Disease on Child Health: A Prospective Birth Cohort Study

Article Publication Date

15-Apr-2023

Disclaimer: AAAS and EurekAlert! Are not responsible for the accuracy of news releases posted to EurekAlert! By contributing institutions or for the use of any information through the EurekAlert system.


Tuberculosis Confirmed At Joppatowne High School In Harford County

BALTIMORE -A case of tuberculosis was identified at Joppatowne High School in Harford County, the county health department confirmed Monday.

According to the health department, a letter and a fact sheet were provided to parents and guardians.

The health department started contract tracing to determine if any students or staff may be impacted.

Tuberculosis is a serious illness that impacts the lungs and is spread from person to person through the air after prolonged exposure.

If a person is showing symptoms. It can be very serious and can be deadly if not treated properly.

Symptoms include cough, sometimes with blood, fever, night sweats, weight loss and fatigue.

"TB is spread through the air from person to person after prolonged exposure in an enclosed space," said Harford County Deputy  Health Officer Dr. Jamie Sibel. "Our investigation is an important step to help prevent the spread of TB."

Elsie Harmon, who attends school online, said she has many friends at the school who texted her about the tuberculosis.

"They don't want to go to school," Harmon said. 

The health department cannot release any information about the person who has tuberculosis or how they may have gotten it for confidentially reasons.

However, Dr. Sible said the department is investigating to see if anyone else has gotten sick..

"We at the health department are going through a contact investigation and we are identifying anyone in the school with a close contact to the affected individual and we will be testing them and treating if needed, Dr. Sibel said.

Dr. Sibel told WJZ active tuberculosis disease cases are rare in the United States, so the vaccine for them is not required for students to go to school.

She also said community members shouldn't be alarmed by this case.

"One is only at risk if they've had prolonged exposure to the person who has been affected," Dr. Sibel said. "So, therefore, this is not a community-wide problem at this time."

However, some parents told WJZ they are worried and wonder if a vaccine should be required.

"I think tuberculosis is a very serious disease and it can spread most, especially, so I think they should vaccinate the kids," said Minister Harmon said. 

For more information on tuberculosis, testing or treatment, call the Harford County Health Department at 410-612-1779 or visit the department's website at www.Harfordcountyhealth.Com.

CBS Baltimore Staff




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