TB: What you should know

Tuberculosis has once again been in the news – do you need to be worried?

Tuberculosis has hit the news again this summer thanks to the case of Andrew Speaker, an Atlanta lawyer infected with a particularly drug-resistant strain of the disease.

He became headline material when he chose to travel by airplane from the United States to Europe – and more significantly, back – in order to be married. He had been diagnosed with TB in the United States but claims he did not know it was of a type called “extensively drug resistant” until he was in Rome. Even so, he boarded a commercial flight to return to the US – and flew through Canada on the way.

Although he was advised not to travel, he told ABC News he did not believe he could pass the disease on to others. Passengers on the flight he took, however, are understandably concerned that they may develop the disease.

What are TB infection and the TB disease?
In order to become infected with tuberculosis, an individual must breathe the TB bacteria into his or her lungs. The bacteria are spread only through coughing and then direct inhalation – it is not transmitted through things like handshaking or sharing dishes. Although this can happen through casual contact, it is much more likely in the case of prolonged contact with someone who has the disease.

Often the immune system is able to kill the tuberculosis bacteria. In some cases, however, the individual’s immune system is not able to respond, and then the infection can become tuberculosis disease. This most commonly occurs in the first 2 years after exposure.

If an adult has the tuberculosis infection he or she may progress to the disease if their immune system is weakened. This happens in about ten per cent of cases (after the initial 2 year period).

The disease itself is a serious disease which attacks the lungs and can spread to other parts of the body. TB in the lungs may cause:
• a bad cough that lasts longer than 2 weeks
• pain in the chest
• coughing up blood or sputum (phlegm)
• weakness or feeling very tired
• weight loss
• no appetite
• chills
• fever
• night sweats

With most strains of the disease, antibiotics can be an effective treatment. Antibiotics can be given in the case of tuberculosis infection to reduce the chances of full-blown tuberculosis disease. In the case of tuberculosis disease, the treatment is lengthy – 6 months or longer, taking more than one antibiotic.

Risk factors
The Public Health Agency of Canada highlights the following risk factors for tuberculosis:
• people born in or travelling to countries where TB is common
• people with an Aboriginal background
• homeless people
• alcoholics
• people who work or live in a prison or jail
• people over 65 years of age
• people who work with any of the above high-risk groups (i.e., health care workers)