Topic: Tuberculosis (TB)
Description
Tuberculosis is a bacterial infection that can affect almost any part of the body but most commonly the lungs - called pulmonary tuberculosis. Although the risk of developing TB is low and it is well controlled in Qld, TB hasn't been eradicated from anywhere in the world, so new cases do occur. TB can be cured by appropriately prescribed medications but can be a very serious disease if not diagnosed and treated.
Symptoms
Tuberculosis seldom begins with striking signs or symptoms. It may progress for weeks or even months before suspicion is aroused; however, there may be:
- A cough that persists for more than 2 - 3weeks
- an irritating hoarseness
- haemoptysis
- persistent or recurring chest pains
- fevers
- night sweats
- a steady loss of weight
- poor appetite
- indigestion
- fatigue
Transmission
Pulmonary TB is almost always spread by inhaling TB germ-containing droplets of moisture expelled directly from the lungs of infectious persons during coughing and sneezing, laughing and speaking.
Treatment
Treatment of TB is based on the use of anti-tuberculosis drugs that are prescribed for at least a six (6) month period, but in some cases the treatment may be prescribed for a longer period. This treatment is known as TB Chemotherapy (unlike Chemotherapy used for other conditions).
The following drugs are usually used to treat TB:
- Isoniazid (INAH)
- Rifampicin
- Ethambutol
- Pyrazinamide
- Prothionamide
- Streptomycin
- Others
Once appropriate treatment is established, the patient usually becomes non-infectious after two (2) to three (3) weeks when normal activities may be resumed whilst continuing treatment. Occasionally some treatment may be required in hospital depending on the doctor's instructions. To ensure cure or prevent recurrence of the disease, it is essential that treatment is taken as prescribed under the direction of the treating doctor for the exact length of time without interruption even if the patient feels improved. Usually medications are given daily but sometimes they may be given three or even two days a week under the direct supervision of a nurse or another designated supervisor. All medication should be taken at the same time (not necessarily swallowed together) each and every day on an empty stomach (ie: one and a half hours before or after food). Most patients find it preferable to take the medications at night before going to bed. As with all medication, there are possible side effects which should be reported immediately to the treating doctor (or local general practitioner or local health authority if outside of business hours).
Health Outcome
Tuberculosis can be cured for most patients providing the anti-tuberculosis medications are taken exactly as prescribed without interruption and under the direction of the treating doctor. Uncomplicated tuberculosis responds readily to treatment in the early stages, but it may become more difficult to treat if the disease is advanced.
Prevention
The most important way to prevent TB is to reduce the source of the germs by diagnosing people with TB and ensuring they are fully treated. By reducing the number of people with infectious TB in the community, the chance of exposure to TB is reduced for the general population. Thus the public health control of the illness depends largely on early diagnosis of disease, isolation of those with infectious TB and ensuring that all patients with TB are successfully treated. Those people with suggestive symptoms should quickly seek a medical check-up to ensure early diagnosis.
Patients with the disease can help prevent infection to others by adhering to the prescribed treatment as instructed by the doctor, even if one is feeling well. Such patients should carry out simple, hygienic precautions such as covering one's mouth while coughing or sneezing. By completing effective treatment, re-activation of the disease is unusual, as is the chance of any remaining disability.
For Persons identified who may have been exposed to a person diagnosed with TB
Among the several investigations used to diagnose TB is the Tuberculin skin test (also known as Mantoux test). This test is primarily used to determine exposure to the infection, rather than the presence or absence of active TB disease. Therefore the Tuberculin Test may be administered to:
- Persons who may have been in contact with a person with diagnosed with TB
- Persons from high TB risk groups
- Migrants from countries where TB is common
- Occupationally at risk persons eg; health care professionals
- Persons travelling to a country where TB is common
A chest x-ray may also used to help exclude the presence of TB for those people who come in contact with a person with TB. It may also be necessary to have follow-up x-rays at intervals following close contact with a person with active TB. If any doubt is raised by the x-ray result, other tests such as sputum tests may be necessary to determine for certain whether or not the person has active disease.
Help and Assistance
The Queensland Tuberculosis Control Centre is a unit of expertise for the detection and treatment of TB in Queensland. In addition to this centre, TB control is also managed through four (4) Regional TB Control Units located in Rockhampton, Townsville, Cairns and Toowoomba.
Main centre
-
Queensland Tuberculosis Control Centre:
Specialised Health Services Building
(Princess Alexandra Hospital campus)
24-28 Cornwall Street, ANNERLEY Q 4151
Telephone: +61 7 3896 3963
Regional TB Control Units
-
Cairns Base Hospital
Esplanade, Cairns 4870
Telephone: +61 7 40 506240 -
Townsville General Hospital
Discovery Drive, Townsville 4810
Telephone: +61 7 47 962860 -
Rockhampton Base Hospital
Canning Street, Rockhampton 4700
Telephone: +61 7 49206211 -
Toowoomba Hospital
Kobi House, Pechey Street, Toowoomba 4350
Telephone: +61 7 46 166445
In addition, help and assistance may be sought from the patient’s treating doctor, any Queensland public hospital or local general practitioner.
Other Resources
Last Updated: 25th July, 2008
Date Valid to: 24th April, 2008
