An open form of tuberculosis is it possible to catch hello. Tuberculosis: ways of infection. Tuberculosis of the lungs: signs and ways of infection. How to lower your body's defenses

The disease, known in the early twentieth century as consumption, which was treated with increased nutrition and exposure to warm climates, is considered deadly to this day.

Does not know the boundaries between races and countries, social strata. Anyone can get sick with this disease, as it is caused by a tubercle bacillus, which is extremely resistant to external influences and is transmitted by airborne droplets, contact and through food.

In contact with

Do all people infected with TB get sick?

The wide distribution of Mycobacterium tuberculosis in the environment creates the conditions for infection of a large number of people. But infection is not a disease. The human immune system is designed to be attacked by viruses and bacteria, and a good immune system suppresses the activity of tubercle bacilli. Mycobacteria simply live in the human body, waiting for an opportunity to attack.

The insidiousness also lies in the ability to develop resistance to drugs, after which it is extremely difficult to destroy it.

Any factor that leads to a weakening of the protective forces of the immune system triggers the mechanism of reproduction of mycobacteria, namely:

• chronic stress;
• chronic diseases;
• metabolic diseases;
• oncological diseases;
• immunodeficiency syndrome;
• drug addiction and alcoholism.

Who gets TB and why

Pregnant women, nursing mothers and children are at increased risk. The defenses of the body of pregnant and lactating women are weakened by hormonal changes. Children's immune system is imperfect, vulnerable to attack by bacteria of any kind, an additional risk factor for infection is the child's inability to maintain strict hygiene rules, which increases the possibility of infection.

A sick person with active pulmonary TB is constantly spreading mycobacteria by coughing. A single cough leads to the dispersion of more than three thousand mycobacteria in the surrounding air. They settle on objects, mixing with dust, after which the dust is inhaled by healthy people. This explains the high rate of infection in people who spend a lot of time in a poorly ventilated area.

There is a high probability of infection with this disease:

• In the hospital ward where the sick are being treated;
• in the barracks for soldiers;
• in a prison cell, where there is a lot of crowding and there is no possibility of ventilation;
• in a school class or kindergarten group, if an adult with an active form of the disease works in the children's team;
• in the apartment where the patient lives.

Ways of infection with tuberculosis

How bacteria enter the body

1. The airborne route is the most common route of infection. Most often, mycobacteria enter the body through inhalation.
2. There is another way that tubercle bacillus enters the human body: food. The milk and meat of sick cows can become a source of bacteria.
3. The intrauterine route is very rare, only when the placenta is infected with mycobacteria during gestation or childbirth.
4. Contact is a rather rare way, but there are cases of infection of milkmaids and butchers from sick animals, and the conjunctiva of the eye is also susceptible to the transmission of mycobacteria in the contact way.

What is the risk of infection through contact

Close contact with a TB patient does not always lead to infection. If a patient is diagnosed with a closed form of the disease, then he does not release bacteria into the air, which means that he is not contagious.

Koch's wand is well protected from external influences, since when it enters the body, it forms a dense and durable capsule around itself. It is this that allows mycobacteria to live in the human body for a long time and the immune system cannot destroy them. As long as the capsule is closed, the bacteria are not dangerous to others.

As soon as mycobacteria lose their protection, forming open wounds in the lungs, a person becomes an active spreader of tuberculosis. Casual proximity to such a carrier on a bus or subway car is not as dangerous as daily communication at work or in the family.

The risk of infection increases with the duration and proximity of interaction with the patient:

• Infection is minimal when meeting on the street or traveling in transport;
• the threat of becoming infected is much greater if tuberculosis in an open form is detected in a work colleague or neighbor on the porch. In this case, daily contact with the carrier of the infection is possible, the stairwell or elevator is seeded with mycobacteria;
• friendly communication with the patient, frequent meetings further increase the possibility of contracting tuberculosis;
• the greatest risk of infection in people living in the same living space with the patient, who have a close relationship. Daily contact with a sick person, joint meals, kisses, sexual life - all this provokes the penetration of Koch's wand into the blood and lymphatic system of a healthy person.

Prevention measures

Vaccination is the main measure to prevent tuberculosis in children.. It contains mycobacteria, which are not capable of provoking the onset of the disease, but are recognized by the immune system as hostile to the body. At the same time, immunity is developed that protects the child from tuberculosis for fifteen years.

Preventive methods to prevent infection are not complicated and available to anyone:

• Hygiene. A rule should be introduced to wash hands as often as possible, especially for residents of cities where the likelihood of meeting a bacillus carrier is much higher;
• Thorough wet daily cleaning of the house with the use of products containing chlorine. Mycobacteria are very sensitive to chlorine, and dusting minimizes the risk of accumulation of bacteria on the surface of the floor and objects;
• daily airing of the house;
• complete nutrition, including meat, eggs, fats and full-fat dairy products;
• walking in the fresh air, playing sports, physical activity - these measures help to strengthen the immune system.

If there is a threat of infection with tuberculosis, contact with a sick person or detection of the carriage of mycobacteria, treatment with chemotherapy drugs is prescribed as an active prophylaxis.

Tuberculosis is transmitted from person to person in several ways.: airborne, contact, food and intrauterine.

That is why, in order to avoid the emergence of an epidemic of tuberculosis, patients are temporarily isolated in special dispensaries.
But at the same time, infection cannot be ruled out during medical procedures.

Therapist: Azaliya Solntseva ✓ Article checked by Dr.

Person-to-person transmission of tuberculosis

How is tuberculosis transmitted from person to person? The disease is caused by microscopic bacteria called Mycobacterium tuberculosis. There are many strains (species) of this pathogen, some of them are resistant to drugs. Every person at risk needs to know about possible routes of infection.

Tuberculosis bacteria are transmitted through the air: by airborne droplets and airborne dust.

When they are in the environment, a person can breathe them in if they are close enough and can be transmitted during:

• cough
• singing;
• conversation;
• sneezing.

Bacteria can sometimes remain in the environment for several hours, especially in small spaces without fresh air. Sunlight greatly reduces the lifespan of microbes, if not immediately destroys them. Fresh air disperses them, reducing the amount in a certain volume.

In many countries the public is not well informed and there are many myths. Misconceptions about the transmission of pathology to others are especially common. Therefore, people may believe that the disease is hereditary or can infect through food and water.

In developing countries, the main consequence is the social isolation of patients both within and outside the family. At home, the patient is forced to eat and sleep separately for fear of transmission.

People with strong immune systems may not have symptoms of TB even if they carry the bacteria. The so-called latent or inactive tuberculosis. According to WHO, about a third of the world's population has latent tuberculosis.

This condition is not contagious, but the active phase of the disease can occur at any time and is dangerous for others and the patient himself. The doctor will explain in detail how to determine the latent form of pneumonia.

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What is tuberculosis

What is tuberculosis and how is it transmitted? Tuberculosis is an infectious disease that primarily affects the lungs. Pathology has been known to mankind since ancient times, then it was called consumption. Now in any Internet source you can find out what mycobacterium tuberculosis is and how the disease spreads.

According to the World Health Organization (WHO), it is the deadliest bacterial disease in the world, killing 1.5 million people in 2014. Tuberculosis is most prevalent in developing countries. Despite this, in industrialized states, new cases are recorded constantly. The disease can usually be prevented and cured with the right approaches.

Anyone can get TB by inhaling the bacteria. They are found in microscopic airborne droplets that are spread when coughed up by patients with an active lung infection or dust. When microbes are inhaled, the immune system—the body's natural defenses—often kills all pathogens, and disease stops.

Otherwise, infection may occur, but it may take several weeks, months, or even years before the onset of symptoms of the disease. This may be due to the presence of, for example, diabetes or HIV, which weaken the body's defenses.

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Symptoms and first signs

An early manifestation of the disease is sweating at night. This symptom is part of the response to the infection, which may continue as long as the person has TB. Night sweats may begin to decrease after starting treatment.

Fever is another early indicator of illness. It starts in the body when trying to eradicate mycobacteria.

The increase in body temperature is usually low and easily controlled with antipyretic drugs. Fever may disappear after starting treatment.

Lack of appetite leads to weight loss in the initial stage of the disease. You can control this by eating high-calorie, nutritious meals and snacks using spices that you enjoy. The doctor, if necessary, may prescribe medication to improve appetite.

Another early sign of pathology is excessive fatigue. It is associated with the increased attention of the body to the fight against infection, which consumes significant reserves of energy and calories. In this case, a person needs more time to rest in order to restore strength.

In some people, at an early stage, this dangerous disease is accompanied by a cough. It is usually mild and not debilitating, compared to a similar symptom in the active phase of the disease.

More often, there is no need to treat a cough, but the mouth and nose should be properly covered with a disposable towel or mask, which, after use, is placed in a waterproof bag and sealed before disposal. After coughing, be sure to wash your hands with soap and water.

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What are the symptoms of tuberculosis?

Some people carry TB bacteria but do not show visible signs of the disease. This condition is known as latent TB or the inactive phase of the infection. The bacteria can remain dormant for years or even decades before they cause active TB.

The above condition causes a variety of symptoms that are most commonly associated with the respiratory system, including hemoptysis and sputum production. Patients at this stage develop a cough that lasts more than three weeks and pain that continues even with normal breathing.

Other symptoms (first signs) include:

• fever (increased body temperature);
• unexplained fatigue;
• night sweats;
• weight loss and appetite (anorexia).

The koch stick usually affects the lungs, but it can also affect other organs such as the kidneys, intestines, and brain. Symptoms of the disease may vary depending on which part of the body is infected. For example, tuberculosis of the kidneys can lead to blood in the urine.

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How it is inherited - opinion

Genetics play no role in the spread and acquisition of infection. The disease is not hereditary, but members of the same family can infect each other. The infection is transmitted between people through the air through microdroplets or dust, but not by inheritance.

The involvement of genetics in susceptibility to TB has long been considered, as early studies showed that the disease was more common in families with a prior history of the disease. Later this concept gained support in groups of people with a rare condition in the karyotype called Mendelian susceptibility to mycobacterial diseases.

These patients have rare genetic defects that lead to severe infections caused by non-infectious bacterial species.

Animals have been widely used to study hereditary infection. There are many studies that show that mice that do not have certain genes are much more likely to suffer from severe forms of this disease.

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Is the virus transmitted through kissing or sexual contact

Is tuberculosis transmitted through kissing? This is one of the most common questions asked about TB. Despite erroneous beliefs, latent TB is not spread through sexual contact and is not a sexually transmitted disease. In addition, bacteria do not infect other people through kissing or touching the skin.

In fact, some also believe that the pathology can be spread through food and water, but this is not true. Tuberculosis is not transmitted through the surfaces of objects such as toilet bowls and even through the use of a toothbrush.

Pathology can spread during a kiss only during the active phase of the disease, when there is a productive cough and the release of mycobacteria with sputum in large quantities. Is tuberculosis sexually transmitted? Transmission through sex is possible, but rare.

It is recommended to consult a physician for a health check and consideration of an anti-tuberculosis regimen, as drug resistance in mycobacteria is a notorious problem that is common these days.

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Diagnosis of lung disease

Medical staff may use a tuberculin skin test (Mantoux test) to determine if a person is a carrier of the bacteria. For this analysis, a doctor or nurse injects 0.1 ml of a special preparation intradermally. Two or three days after the injection, you can find out the result.

If there is a swelling on the skin of more than a certain diameter, then this indicates that the patient is a carrier of microbes. The test will only show the presence or absence of tuberculosis, but will not answer the question regarding the stage of infection: latent or active.

The analysis is not perfect. Some people do not respond correctly to the test, even if they have TB.

Individuals who have recently received a vaccine for the disease may test positive but do not have TB. If the Mantoux test is positive, the patient will be sent for a chest x-ray, which checks for small spots in the lungs. They are a sign of infection and indicate that the body is trying to isolate the TB bacteria.

If the chest x-ray is negative, and the analysis is positive, then a latent form of pathology can be implied. After that, treatment for latent tuberculosis will be prescribed to prevent the activation of bacteria and prevent the development of a more complex condition.


The doctor may also order tests to examine sputum or mucus obtained from the lungs to check for the presence of TB germs. If the sample is positive, this means that the patient can infect others, so he must wear a special mask until treatment begins and the tests are negative.

Sometimes a blood test is done to help identify the hidden process. It cannot tell if you have an active infection.

The advantage of the test is that it does not give false positive results in people who have received a vaccine against the pathology. The limitation concerns false positives within a short time after the initial infection.

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Effective treatment of the disease

Many bacterial infections can be dealt with within a week or two of antibiotics, but disease is different. People with this diagnosis usually have to prescribe several medications over a period of six to nine months.

It is necessary to undergo full treatment, otherwise there is a very high probability that the tuberculosis infection will be able to return. If the pathology recurs, the microorganisms will already be immune to the action of some antibiotics. The doctor prescribes several drugs because many types of bacteria are resistant to certain types of drugs.

The most common medications include:

• isoniazid;
• pyrazinamide;
• rifampin (rifadin, rimactan);
• ethambutol (miambutol).

High doses of antibiotics can harm the liver, so people taking anti-TB drugs should be aware of symptoms associated with liver damage, such as:

• fever lasting more than three days;
• unexplained nausea or vomiting;
• yellowing of the skin and mucous membranes;
• dark urine;
• loss of appetite.

Tell your doctor right away if any of these symptoms occur. Patients should also have periodic liver tests while taking anti-TB drugs.

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Proper prevention for people

Most people in areas with a high risk of developing the disease are vaccinated against tuberculosis in childhood. The vaccine is called BCG and only protects against certain types of microorganisms.

The presence of mycobacteria does not necessarily mean that a person will have symptoms of active TB. If there are mycobacteria in the body and there are no signs of infection, the doctor may prescribe prophylactic antibiotics to prevent the disorder from developing to an active stage. A common medication for these purposes is isoniazid, which must be used for six to nine months to completely kill the germs.

People who have been diagnosed with the disease should avoid crowded places.

According to the WHO, people with TB can infect 10 to 15 people a year through close contact if they don't take precautions.

People who are affected must wear a surgical mask to prevent the spread of germs in the air. It is best for a person with an active form of the disorder to avoid contact with other people until after the first three to four weeks of treatment.

For personal prevention of infection, it is necessary to undergo research in a timely manner, observe the rules of personal hygiene. For employees at risk of infection, it is necessary: ​​regular medical examinations, personal hygiene, cleaning of premises.

- a pathology in which the spread of the virus occurs, in most cases, when coughing.

When mycobacteria enter the lung tissues, cell destruction begins, with the formation of deep cavities.
Without timely treatment, a patient with active tuberculosis may die.

Active TB is a condition in which the body's immune system is unable to fight TB bacteria, so bacterial excretion develops into the external or internal environment. Microorganisms spread through the air and usually affect the lungs, although they can involve other organs and parts of the body in the pathological process.

If the body's resistance is low, for example due to aging, malnutrition, infections such as HIV, or other reasons, the bacteria become active and cause an open form of tuberculosis.

The World Health Organization estimates that every year 8 million people worldwide develop an active form of the disease and almost two of them die. One in ten infected with pathogens may develop open tuberculosis. The risk of development is greatest in the first year after infection, but the form often develops many years later.

It is impossible to immediately infect with an open form of the disease, since it is necessary to go through its first phase. When the TB germs enter the body, they are inactive.

Dormant microbes do not damage the body or cause symptoms of disease. This is called latent TB infection.

It may last for a short time or for many years. When microbes are activated, begin to grow and damage the body, then specific signs of pathology appear. This is called active or open tuberculosis.

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The main symptoms of pathology

Manifestations of active tuberculosis depend on the individual characteristics of the organism.

An open form of tuberculosis can cause symptoms such as:

• a productive cough that lasts 3 weeks or longer
• chest pain;
• secretion of sputum with blood impurities.

Nonspecific signs may include:

• weakness or fatigue;
• weight loss;
• anorexia;
• chills;
• fever
• night sweats.

These possible symptoms of tuberculosis are not reliable signs of the disease. Other health problems can also cause these signs. Any person with likely manifestations of the disease should see a doctor as soon as possible so that the problem can be diagnosed and treated in a timely manner.

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The risk of infection - how you can get infected with a pathology

How can you get an open form of tuberculosis? Anyone can contract a dangerous disorder. When someone with TB in the lungs coughs, sneezes, or talks, the germs can be sprayed into the air. Nearby people may inhale the agents. It is impossible to catch the disease from shaking hands or from food, utensils, bed linen and other items. People with weak immune systems are more susceptible to infection.

How can you get infected:

• abusing alcohol or drugs;
• having diabetes;
• with silicosis;
• having head or neck cancer;
• in the presence of leukemia or Hodgkin's disease;
• when diagnosing severe kidney disease;
• having a low body weight;
• during certain types of treatment (eg, corticosteroids or organ transplant);
• during the period of specialized therapy for rheumatoid arthritis or Crohn's disease.

If pathogens are in the lungs, you must be careful to protect other people from germs, as the risk of infection with open TB increases several times. Ask your doctor or nurse, they will tell you what to do to prevent passing germs to family and friends and how you can get infected yourself.

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How long do people live with this disease?

Pathology does not always lead to death. Without treatment, life expectancy can range from 5 to 30 years, how long they live with an open form of tuberculosis depends on many external and internal factors.

First of all, the body's immune resistance, as well as age and the presence of concomitant diseases, influence.

You can expect to keep your job, stay with your family and lead a normal life if you get TB. However, you must take the medicine regularly to be sure of a positive trend and to prevent infecting other people.

After therapy, the chance for a complete recovery is very high, but not 100% guaranteed. There are especially severe forms of the disorder that are practically not susceptible to most antibacterial drugs.

Therefore, the importance of following the prescribed exposure regimen cannot be underestimated. Without treatment, the disease will progress and can lead to disability and even death.

Poor prognosis for life and high risk creates smoking more than 20 cigarettes per day. This increases the chance of pathology and dangerous complications by two to four times. Diabetes also worsens the prognosis of the disease.

Other painful conditions that reduce the chances of recovery:

• alcoholism;
• end stage kidney disease;
• malnutrition;
• Hodgkin's lymphoma;
• chronic lung diseases.

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Open and closed form - comparison

People with a latent infection do not get sick and do not have any symptoms. They are infected with mycobacterium M. tuberculosis (Koch's bacillus) but show no signs of disease.

The only confirmation is a positive tuberculin skin test or blood test for tuberculosis. Persons with a latent form are not contagious to others.

In general, without treatment, 5-10% of infected people develop an open form of the disease at some point in their lives. In half of them, this will happen within the first two years after infection.

Individuals with a weak immune system, especially those infected with HIV, are much more likely to develop an active form of the disease than those with normal body defenses.

In a person with latent TB infection:

• usually a skin test or blood test result indicates an infection;
• a normal chest x-ray and a negative sputum test;
• tuberculosis bacteria in the body are alive but inactive;
• no symptoms;
• microorganisms are not spread to others.

In some people, the bacteria overcome the defenses of the immune system and begin to multiply, leading to progression from a closed to an open form of pathology. Some fall ill shortly after being infected, others later when their body's response becomes weak.

People are considered contagious to the surrounding society. If suspected, patients should be sent for a full medical examination.

Open tuberculosis is a very serious disease and can lead to death if left untreated. The closed form is always dangerous because a person cannot start drug therapy in a timely manner.

In an infected person with an open form:

• a positive skin test or blood test result indicating infection
• abnormal chest x-ray or positive sputum smear and culture;
• there are active tuberculosis bacteria in the body;
• numerous symptoms appear, such as cough for 3 weeks or longer, hemoptysis, chest pain, unexplained loss of weight and appetite, night sweats, fever, fatigue and chills;
• spread of bacteria to others may occur;
• treatment is mandatory.

The first signs of the disease

Manifestations of tuberculosis usually develop slowly, over several months and years, often masked by other conditions. Bacteria multiply very slowly, so the symptoms of the disease also appear slowly, usually from several months to many years. Many of the symptoms are vague and may have other causes.

The classic manifestations of active tuberculosis are:

• malaise;
• night sweats;
• generalized pain in the body;
• periodic fever;
• weight loss and appetite;
• fatigue.

Of the specific symptoms - the first signs of an open form of tuberculosis is a constant cough, which in the morning can be with yellow or green sputum. Over time, traces of blood appear, although a large amount of it is unusual.

Cough is often thought to be related to smoking, asthma, or a recent illness, but TB is overlooked. Pathology causes increased night sweating, while the person wakes up, soaked in sweat.

As the disease progresses, fatigue and malaise increase, and weight and appetite loss progresses. Other common early symptoms are chest pain and shortness of breath. They can result from a pleural effusion, a buildup of fluid between the thin membranes that cover the lungs and the inside of the chest wall.

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Tuberculosis and the incubation period

The microbacteria Mycobacterium tuberculosis have an incredibly low infectious dose of less than 10 microorganisms to initiate disease. The bacteria have a long incubation period of two to twelve weeks with a range of fourteen days to several decades.

They have the ability to both hide and initiate an active form of the disease. Mycobacteria inhaled by the host infect the lungs and are taken up by alveolar macrophages. After that, they can remain dormant for a long time or begin to multiply inside these cells, which causes the appearance of an open infection.

The duration of tuberculous incubation varies according to individual risk factors.

Within six weeks of being infected, an infected person has been reported to develop a primary infection in the lungs that has no symptoms.

The disorder then enters an inactive phase, which can last from a few weeks to several years. The incubation period may be prolonged. Therefore, everyone who comes into contact with a potentially infected person is at risk of becoming infected.

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How to protect yourself from an open form of tuberculosis

Vaccination can help protect against the disease. Infectious disease is quite common among children. BCG is given to all infants in countries where the disease is common.

In states like the UK, it is recommended for those at high risk. Before vaccination, a person is given a Mantoux skin test to detect the presence of latent tuberculosis. The infection is considered the most dangerous for babies.

Prevention consists of two main stages:

• prevent the appearance of people with an active phase in crowded places;
• preventing the development of the active phase in people with latent tuberculosis.

How to protect yourself at home:

1. Houses should be adequately ventilated.
2. Anyone who coughs is required to learn respiratory etiquette, respiratory hygiene and adhere to learned practices.
3. With positive smear results, TB patients should:

• spend as much time as possible outdoors;
• sleep separately from other family members, in a well-ventilated area;
• spend as little time as possible in public transport and in places where a large number of people gather.

Treatment of patients with a closed form of the disease is the most effective method of protection against an open form of the disease.

Many people with a latent infection never develop active disease.

A special high-risk group is:

• people with HIV infection;
• persons who have become infected in the last 2 years;
• infants and young children;
• drug addicts;
• elderly.

If you have a latent infection, you need to take medication.

Tuberculosis belongs to the category of infectious diseases that have long troubled mankind. Despite the high level of modern medicine, the disease is quite common in modern society. To reduce the risk of damage by the causative agent of pathology (Koch's wand), it is important to know whether tuberculosis is contagious. Experts say that the infection is easily transmitted from sick people to healthy people, and requires the adoption of effective security measures.

Forms of tuberculosis

After entering the human body, the tubercle bacillus (mycobacterium) “travels” along with the blood and lymph, and most often settles in the lungs. In the affected areas, specific tubercles are formed - single or multiple.

In the presence of certain factors, the disease takes one of the main forms:

• closed;
• open.

With a closed variety of pulmonary pathology, the infection does not go beyond the affected area, and the patient himself does not feel obvious symptoms of the disease. Tuberculosis is also difficult to detect on x-rays, in sputum tests. The only sign indicating the presence of a closed pathological process is a positive tuberculin test.

The course of an open form of the disease leads to the entry of a pathogenic microorganism into bronchial, pulmonary mucus, and other liquid media of the human body. This type of tuberculosis is manifested by vivid symptoms, deterioration in general well-being, and requires effective therapy under the supervision of specialists.

According to WHO (World Health Organization) statistics, the closed form of tuberculosis predominates in the world. The latest data claim that about a third of the world's population is affected by this form of pathology.

Is it possible to get infected from a patient with a closed form of the disease

The wide distribution of the closed form of tuberculosis requires an understanding of whether this type of disease is contagious or not. With the development of this form of the disease, a person acquires the status of a carrier of the infection, but does not pose a danger to others. This is due to the fact that Koch's wand is not released into the environment. It is for this reason that patients with a closed type of pathology are not subject to mandatory hospitalization, they undergo outpatient treatment under the supervision of a doctor.

Some experts argue that the closed form of pulmonary tuberculosis can be dangerous for people who have a weakened immune system. The most vulnerable categories are young children, the elderly, and pregnant women.

Despite the fact that closed tuberculosis is practically not contagious, it tends to become open over time. For this reason, a patient infected with Koch's bacillus must be constantly monitored by a phthisiatrician and undergo the necessary medical examinations in a timely manner.

The risk of infection with open TB

The transition of the closed type of the disease to the open variety occurs in 5-10% of patients. In this case, tuberculosis becomes contagious, the patient becomes a danger to healthy people, which requires his placement in a medical institution and an intensive course of therapy.

Unlike the closed form of the disease, the open one causes the appearance of vivid symptoms:

1. Incessant cough.
2. Hemoptysis.
3. Increase in body temperature.
4. Pain in the chest.
5. Shortness of breath.
6. Nocturnal hyperhidrosis (profuse sweating).
7. Chill.
8. General weakness.
9. Loss of appetite.
10. Sudden weight loss.

Upon contact with a person suffering from open tuberculosis, the probability of transmitting the infection to others reaches 30-85% (depending on the state of the immune system).

Ways of transmission of infection

The causative agent of tuberculosis can enter the human body in several ways:

• airborne (through the spread of mycobacteria in the air and their inhalation);
• alimentary (associated with the use of products that have “contacted” with a sick person, or obtained from infected animals);
• household contact (in this case, infection occurs through household items, but this method of infection is much less common);
• intrauterine (infection affects the fetus in the womb of a sick mother);
• hematogenous (with direct contact with the pathogen in the blood).

It is not necessary to exclude the possibility of contracting a tuberculosis infection through sexual contact. In this case, the causative agent of the pathology can enter the body of a healthy partner with kisses, the presence of microdamages in the genital area.

It is important to understand that mycobacteria that have entered the body do not always provoke an acute course of the disease. Often the infection develops latently, activating only in the presence of "favorable" circumstances.

Risk group - who is most susceptible to infection with Koch's wand

Tuberculosis risk groups are divided into several categories:

• social.
• medical.
• epidemiological.

Each group of factors conducive to the development of a dangerous pathology is characterized by its own characteristics of the impact on the incidence rate.

In order to control the spread of tuberculosis, there are specialized services that record tuberculosis risk groups in a particular region.

Social risk group for tuberculosis

1. Poor citizens.
2. Homeless people.
3. Refugees.
4. Migrants.
5. Prisoners.

The group of people who can get sick also includes orphans and children brought up in dysfunctional, low-income families.

Medical factors

The increased risk of infection is associated with various medical factors. The likelihood of developing the disease is especially high in the following cases:

• in the presence of acute diseases of the respiratory system with a prolonged course, frequent pathologies of the upper and lower respiratory tract (recurring from 5 to 6 times a year);
• with damage to the lungs by chronic infectious and inflammatory processes;
• against the background of transferred or recurrent inflammation of the pleura;
• with the release of sputum with blood, the development of pulmonary bleeding.

Patients with diabetes mellitus, ulcerative lesions of the digestive organs, suffering from prolonged soreness in the joints, swollen lymph nodes of an unknown nature, undergoing intensive courses of hormonal or radiation therapy are also prone to tuberculosis.

Persons with such disorders should be under the constant supervision of physicians (therapist or physiatrist).

Epidemiological risk group

This group consists of people who have an increased likelihood of lung due to medical reasons:

• regularly or periodically in contact with patients with an open form of pathology (medical staff, relatives of patients);
• persons who have a closed form of the disease.

Ways to protect against tuberculosis infection

To reduce the risk of developing tuberculosis, a general vaccination is provided. The first vaccination (BCG) is given to children immediately after birth. Repetition of the injection is provided after the baby reaches 7 years of age.

medical fact. Vaccination helps to reduce the likelihood of Koch's bacillus, but does not guarantee 100% protection against a dangerous disease.

1. Annual passage of a fluorographic examination of the chest (upon reaching the age of 15).
2. Compliance with cleanliness in the room, regular wet cleaning, airing.
3. Destruction of household pests (flies, cockroaches, cockroaches, mice, rats) that can spread tuberculosis infection.
4. Complete nutrition with an emphasis on the use of protein products, fresh fruits, vegetables, high-quality butter, milk and cottage cheese.

It is important to wash your hands often with soap and clean exposed areas of the body after visiting crowded places. During the off-season and during the cold season, it is worth taking multivitamin preparations that support the body in the fight against bacteria and viruses.

Tuberculosis is an infectious process that has not lost its danger throughout the thousand-year history of mankind, yielding in importance, perhaps, only to plague and cholera.

If in the period of 70-80 years Soviet medicine managed to keep the process of morbidity and treatment under control, then with the collapse of the preventive system of Soviet health care, the intensification of migration processes and the greater openness of the post-Soviet space, the situation has noticeably worsened.

Today it is no longer necessary to calm oneself down with the thought that tuberculosis is a disease of antisocial strata of the population. Incidence statistics show that any person, regardless of their income and diet, having errors in immune protection, has every chance of getting tuberculosis.

At the same time, a trend appeared in which the chances of the poor and the rich were equalized. Often, young, well-to-do mothers, weakened after childbirth, turn to them for pulmonary problems, which, when examined, turn out to be one form or another of tuberculosis.

That is, today the situation in terms of morbidity has fallen approximately to the level of the beginning of the 20th century, when the intelligentsia was ill with tuberculosis no less than the city lumpen. Today, about 60 million people are affected by tuberculosis in the world.

Pathogen

Mycobacterium tuberculosis is also called Koch's bacillus or tuberculosis bacillus, because it looks like a stick. It grows slowly on solid nutrient media, but quickly forms membranous formations on the surface of the liquid. Bacteria do not emit any toxins, so the moment of infection with them may well pass unnoticed without signs of intoxication.

As the rods multiply and accumulate in the body, an allergic reaction to them appears with the introduction of tuberculin (positive or hyperergic Mantoux test). If a mycobacterium cell is eaten by a macrophage leukocyte, then it may well live inside it, and then enter the bloodstream and cause a tuberculous process. Also, similarly to chlamydia, mycobacteria turn into L-forms, which, without multiplying, exist vegetatively inside the cells.

Mycobacteria in the environment

The infectious agent is resistant to almost all environmental factors:

• Bacteria can live in water for up to six months
• On the pages of books - about 3 months
• At room temperature with a humidity of more than 70%, the mycobacterium can live for about 7 years.
• If the dust contains dried sputum of a patient who excretes bacteria, then they live for another 12 months.
• In street dust with diffused lighting - 2 months, in the ground - up to six months.
• In the raw milk of sick cows, the sticks live for 2 weeks, in cheese and butter for up to 12 months.

When does Koch's wand die in the external environment?

• Koch's sticks do not tolerate only ultraviolet light - bactericidal lamps kill them in 2-3 minutes, and direct sunlight in two hours.
• When boiled in dried sputum, the death of microbes occurs in half an hour, in wet - after 5 minutes.
• In six hours, you can kill bacteria with chlorine disinfectants.

Ways of transmission of tuberculosis

The bulk of those infected receives mycobacteria by aerogenic means from people with tuberculosis.

• Either airborne from a sick person (when talking, sneezing, coughing), or airborne, inhaling the pathogen along with dust.
• The contact-household way (with common utensils, hygiene products, bed linen, towels) also does not lose its relevance.
• The food route, also called the alimentary route, is realized through food or water infected by sick people or animals (usually cattle). But today, cases of infection from sick cows are rare: unboiled milk and home-made dairy products.
• Rare ways of infection also include transplacental from mother to fetus.
• Small children can become infected by contact, in which the penetration of mycobacteria is possible through the conjunctiva of the eyes.

The risk of infection is higher from a person who excretes mycobacteria, lower - from a patient with extrapulmonary forms of tuberculosis. The longer a person is in the presence of mycobacteria and the higher their concentration in the inhaled air, dust, water or food, the higher the likelihood of infection.

The causative agent in the body captures the leukocyte-macrophage. In this case, the fact of infection does not mean the development of the disease. Thanks to passive (after BCG) or own immunity, a person only carries mycobacteria in himself. Only with failures in the immune defense does the inflammatory process begin to unfold.

Is TB transmitted through doorknobs?

It is possible to catch tuberculosis by grasping the door handle after the patient has used it, only if there is a dense layer of dust on the handle. The patient is excreting Koch's bacilli and coughed directly on the pen before you took it. In other cases, this route of infection tends to zero.

It is also unlikely to be infected by shaking hands (except when the bacillus excretor coughed into a fist, and you, while vouching for it, inhaled vigorously, bringing your hand to your nose or mouth). In general, it is a good idea to make it a rule to at least occasionally treat common areas (including doorknobs) with chlorine-containing detergents. By the way, alcohol and acids have no effect on mycobacteria. In addition to bleach, hydrogen peroxide can be used for disinfection.

What happens after infection?

Most often, infection occurs in childhood, but some people can become infected as an adult. Since the main route of infection is aerogenic, most often the stick enters the lung tissue directly under the pleura. Here it causes a focus of cheesy necrosis, ranging in size from a pinhead to a cherry. For the first time, this element of inflammation was described by the Prague professor Ghosn, in whose honor it was described and called the hearth of Gon.

Since in most cases there is an immune response to mycobacterium, the focus gradually closes, becomes saturated with calcium salts and turns into petrificate (small pebble). Such stones are often found during autopsies in people who did not have tuberculosis and died from other causes. This confirms the high incidence of tuberculosis in the population, as well as the dependence of the onset of clinical manifestations and advanced disease on the state of immune protection. That is, whether the disease develops after infection or not depends on the state of immunity of the infected.

Closed tuberculosis: how is it transmitted

Closed tuberculosis is said to be when there is no release of mycobacteria into the external environment. At the same time, a person who gets infected by any of the possible ways (most often aerogenic or contact household, less often food) gets sick with a closed form of tuberculosis. The patient himself will not be able to infect anyone until the moment when his form of the disease leads to the destruction of the affected organ (usually the lung) and causes the release of Koch's sticks into the external environment with sputum, urine, tears.

Open tuberculosis: how is it transmitted

Infection with open tuberculosis occurs, as well as closed. In this case, the patient releases mycobacteria into the outside world and is dangerous to others. When sputum cultures in the analysis, Koch's sticks are detected. So patients with an open form of pulmonary tuberculosis usually infect close relatives, colleagues or acquaintances with a large number of microbes with high virulence, resulting in the development of a primary tuberculosis complex.

Problems of modern phthisiology

Having achieved quite tangible results in the containment of tuberculosis in the second half of the 20th century, specialists dealing with this infection (phthisiatricians) from the end of the nineties began to face problems that were previously considered a closed issue.

A patient with an open form of tuberculosis (bacilli excretor) per year in the most regular mode is able to infect from 15 to 20 people who do not live with him in the same living quarters and do not come into close contact. That is, in transport, in the store, at the workplace.

What was and what is now

With this in mind, in the Soviet period, phthisiology in places of detention was of a coercive-punitive nature, the treatment of patients was mandatory and continued (if necessary, under the supervision of a local policeman) even after the release of the patient, that is, at his place of residence. The patient with an open form was entitled to extra square meters to reduce the risks for those who lived with him (and these meters with a creak, not always, but they were issued).

Today, no one can force a citizen to be treated forcibly from the tuberculosis process. A person may, of their own free will, interrupt therapy when they see fit. Even if phthisiatric care was provided to the patient in places of deprivation of liberty (which today is not always and everywhere), then after that he may refuse to continue treatment.

Using some TB drugs to treat other conditions

Breathing a sigh of relief after the introduction of anti-tuberculosis drugs, which gave a high percentage of cure, the phthisiatricians were clearly in a hurry. Today, most of the means used no longer give such brilliant indicators, due to the adaptation of pathogens to them.

Rifampicin adds its own five cents to the habit of some doctors or patients to resort to anti-tuberculosis drugs to treat other infections. So, having been treated a couple of times for staphylococcal furunculosis with rifampicin, you can forget about the anti-tuberculosis effect of this drug.

Fluoroquinolones - On all corners, phthisiatricians appeal to the mind of pharmaceutical companies, insisting on keeping fluoroquinolones in the group of reserve antibiotics. Fortunately, in our country they are at least strongly discouraged from being used in pediatric practice. Nevertheless, quite often doctors and pharmacists recommend fluoroquinolones as more effective (and expensive) agents for the most mild infections, still sensitive to cephalosporins, penicillins or macrolides. Commercial profit, the desire to cure the infection without a hitch, leads to dire consequences, leaving a person without any chance in the future.

Mycobacteria resistance problem

The problem of resistance is not limited to the gradual adaptability of Mycobacterium tuberculosis to known antibiotics. Today, cases have already become a reality when a person becomes infected with an already resistant bacterium. That is, it was not in the body of this patient that the bacterium acquired resistance, but already came to him initially stable. It is this sad fact that explains the beds in anti-tuberculosis hospitals, on which are actually suicide bombers, who cannot be helped radically by anything, but can only alleviate their suffering.

In addition, phthisiatricians often face the problem of severe tolerability of treatment by TB patients. Anti-tuberculosis drugs are very toxic, and today, due to mass allergization of the population (including drugs) and the presence of contraindications for the use of one or another anti-tuberculosis drug in patients, the course of treatment is delayed and the patient's chances for a full recovery are reduced.

An increase in the number of destructive forms

This is another feature of modern tuberculosis. Some 30-40 years ago, it was impossible to show cavities and fibrinous decay of the lungs to students in dispensaries or hospitals. Today, destructive tuberculosis is not uncommon. It is also worth noting that HIV-infected people in our country most often die from tuberculosis.

Difficulties in diagnosis

Tuberculosis is a very insidious, difficult-to-diagnose disease, since some of its forms are often disguised as other pathologies (see). It is especially difficult to diagnose extrapulmonary forms of tuberculosis, the symptoms of which are no different from nonspecific inflammatory processes in other organs (kidneys, joints, spine, lymph nodes, genitals, etc.), instrumental diagnostic methods do not indicate the tuberculous process with 100% accuracy, doctors of the general medical network are deprived of additional methods of specific diagnostics and often tuberculosis alertness.

Pediatric phthisiology also has a lot of problems.

There is a huge number of tuberculosis-infected children whose parents categorically refuse preventive treatment, attending kindergartens and schools. At what point a child with a hyperergic Mantoux test will have a detailed picture of the tuberculous process, no one can say. How much time will pass before contacting a phthisiatrician, making a diagnosis and isolating the baby from his own kind is also a matter of chance.

BCG vaccinations

The hysteria surrounding the vaccination campaigns is idiotic. BCG has been done, is being done and will be done by all reasonable pediatricians to children of reasonable parents (see the opinion of the candidate of medical sciences on the BCG vaccination and its consequences, as well as on diaskintest and Mantoux - one does not replace the other). No one is calling for blanket vaccination of all newborns indiscriminately.

There are certain contraindications and certain categories of children who should not be vaccinated in the first days after birth. For such children, there is a pediatric phthisiatrician and an immunological commission, which give their recommendations on the timing and rules of vaccinations.

But for a healthy child whose family does not currently have tuberculosis patients, BCG is a real chance, faced with a tuberculosis infection, not to join the ranks of hopelessly ill patients, escaping in the worst case with a mild form of the disease. No need to rely on the fact that in the old days no vaccinations were given to children.

• Firstly, then natural selection worked, and only the strongest with wealthy immunity survived,
• Secondly, the incidence of tuberculosis among children cannot even be closely compared with late Soviet and even present times.

In conclusion, tuberculosis is a dangerous disease with several routes of infection, and it is almost impossible to completely eliminate contact with them today. That is why the fight against tuberculosis should be aimed primarily at strengthening the body's immune response.