His body was emaciated, his skin was pale, his face was peachy, his eyes were melancholy, and he took out a handkerchief from time to time and covered his mouth. This image once appeared in "Dream of the Red Chamber" and "La Traviata". Even, a famous poet named Baito once said that he wished to die of this romantic disease, which was tuberculosis. However, the reality is not romantic, but full of desolation, and more than 10 million people around the world still have TB, of which 1.1 million are children. Tuberculosis, with a long history, still threatens human health today. March 24 is World TB Day, so let's review the key points and learn the truth about this ancient killer.
Ordinary people may not think that tuberculosis is the 13th cause of death and the 2nd infectious disease killer, surpassing AIDS, and the number of deaths is second only to the new crown virus that is now prevalent. In 2020, a total of 1.5 million people died from TB, of which 214 000 were people living with HIV. Drug-resistant tuberculosis is a public health crisis. Although the cumulative incidence of TB has decreased by 11% between 2015 and 2020, only about 30% of patients with drug-resistant TB have been treated, which is an important reason for the high fatality rate. 24 March, designated world day to fight tuberculosis, is in honor of Dr. Koch, a pioneer in the field of microbiology, who announced on March 24, 1882, that the pathogen of tuberculosis had been discovered, and that a target had been found to diagnose and treat the white plague. But more than 100 years later, more than 30,000 people are still infected every day in the global village, and more than 4,100 people have died from tuberculosis.
Tuberculosis, or TB for short, is caused by infection with Mycobacterium tuberculosis. Mycobacterium tuberculosis, which is transmitted from person to person mainly through the air, is mainly through lung infection. In patients with tuberculosis, when coughing, spitting, and sneezing, Mycobacterium tuberculosis will enter the air, spreading faster and affecting the surface. South African scholars have done a study, the results found that tuberculosis patients in normal breathing, deep breathing, cough, will release gas particles, 5 minutes later, these aerosols contain Mycobacterium tuberculosis, cough production of gas particles, 3 times the time of breathing. In addition, some tuberculosis patients have no symptoms, but they can also spread Mycobacterium tuberculosis through aerosols, and people around them may become infected by absorbing a small amount of air containing pathogenic bacteria.
Mycobacterium tuberculosis, after entering people's respiratory tract, can cause lung infections. About 25% of us have been infected, but most of the infected people do not get sick and do not spread the disease. The incidence of the disease in infected people is about 5% to 10%, and people with compromised immune systems such as people living with HIV or AIDS, malnutrition or diabetes, alcoholics or smokers, are at higher risk of developing the disease. Active TB patients, within 1 year, can infect 5 to 15 people through close contact, HIV-infected people are 18 times more likely to develop active TB than others, malnourished people have a 3 times higher risk of disease than others, alcohol-dependent people and smokers, the risk of tuberculosis increased by 3.3 times and 1.6 times, respectively.
Mycobacterium tuberculosis, after causing infection, the immune system responds quickly, and in most cases, the bacteria are cleared by macrophages. If autoimmune function is poor, Mycobacterium tuberculosis multiplyes in macrophages, forms colonies in lung tissue, and infects more cells, while releasing enzymes that break down cells, causing chest pain and coughing up blood. When lung damage is severe, it can cause oxygen deficiency, resulting in decreased appetite and iron deficiency, and patients will experience weight loss and anemia. If the causative bacteria spread to the bones, back pain and mobility difficulties can occur. If the kidneys and intestines are infected, abdominal pain and low back pain may occur. Pathogens spread to the brain, causing headaches and changes in consciousness. If the reproductive system is infected, it can lead to infertility.
After infection with Mycobacterium tuberculosis, common symptoms are low-grade fever, fatigue, weight loss, night sweats in the afternoon, and women with irregular menstruation or menopause. Active tuberculosis, a common symptom is cough, sometimes accompanied by sputum production and blood in sputum, chest pain, fatigue, weight loss, fever, and night sweats. Tuberculosis of the digestive tract, stomach discomfort, acid reflux, belching. The most important test to diagnose tuberculosis is a tuberculin test. A positive test indicates a previous infection, and if the dilution test remains positive, suggests the presence of an active tuberculosis foci in the body. It should be noted that most mycobacterium tuberculosis will lurk in the human body, be in a resting state, and only begin to be active when immune function declines. As a result, the rate of missed diagnosis of tuberculosis is relatively high.
Tuberculosis is preventable and treatable, and the key is early detection. After the diagnosis, antibiotic treatment needs to be carried out in accordance with the principles of combination, appropriate amount, regularity and whole process to prevent drug resistance. As a rule, a complete cycle of treatment requires the use of 4 antibiotics for 6 months. If isoniazid and rifampicin first-line anti-TB drugs are used and there is no response to treatment, it is drug-resistant TB, requires initiation of second-line drugs, takes 2 years of treatment, and has more adverse reactions. Severely drug-resistant TB may remain unresponsive to second-line drugs, resulting in a situation where there is no cure. The main measure to prevent tuberculosis is to vaccinate BCG, which has been successfully studied as early as 1921 and has been widely used since 1924, but BCG is not well protected against tuberculosis in adults. The prevention of tuberculosis also needs to enhance immunity through reasonable diet, physical exercise and other ways, and those who are in close contact with patients with active tuberculosis, children, malnutrition, chronic diseases or people with decreased immune function need to take anti-tuberculosis drugs for preventive treatment if necessary.
Whoever loves, pass on health to whom.
Your health, my concern. Professionals observe health from a scientific and humanistic perspective, including a series of express reports, details, reminders, doubts, observations, opinions, historical stories, etc., with the content of the original works of the author Wei Hongling and the team. All forms of misappropriation and reproduction without permission will be refused, otherwise they will be prosecuted in accordance with relevant laws.