Does not suffer from tuberculosis. Who is at risk. The phthisiatrician answers. Ask a question online

Now almost everyone knows how difficult the situation with the incidence of tuberculosis in countries post-Soviet space. Poor financing of health care, insufficient coverage of the population with vaccination, unfavorable ecology, deterioration of material and living conditions, bad habits- all these factors contribute to a decrease in immunity, the formation of resistant types of bacteria that are not amenable to therapy standard schemes which leads to an increase in the incidence and complication of the fight against tuberculosis.

Most main question that worries any person is the risk of infection in everyday life. How not to get sick? - let's figure it out.

The possibility of contracting tuberculosis is quite high, but still the risk is low compared to highly contagious diseases such as HIV, viral hepatitis, measles, etc. The main source of infection in tuberculosis is a sick bacterioexcretor.

Depending on the form of the tuberculosis process, patients may not excrete bacteria:

In pulmonary forms, bacterial excretion requires the presence of destructive lesions in the lungs. Otherwise, destructive forms of tuberculosis were previously called "open".

So how can you get infected?

Tuberculosis transmission mechanisms:

Can you get infected through kissing?

Yes, you can. Subject to contact with a patient who is a bacterioexcretor and a large amount of the pathogen enters the damaged (cracks, cuts) mucosa. In this case, a tuberculous chancre is formed.

It is also possible to ingest mycobacteria and develop intestinal form tuberculosis.

Where can you get TB?

Robert Koch said: "As long as there are slums on earth where the sun's rays do not penetrate, consumption will continue to exist." breeds well in a humid, warm environment, unsatisfactory home conditions.

In conditions large cluster people in enclosed spaces without adequate ventilation, mycobacterium thrives. Settling on the surface of objects and mixing with dust, it can be in a viable state for many weeks and months.

Is it possible to get infected on the street?

The chances of contracting TBC outdoors are quite low. Getting into environment, mycobacterium disperses in the air and dies very quickly under the influence of ultraviolet rays. Thus, on outdoors the concentration of bacteria necessary for infection is reduced.

Influencing mycobacterium ultraviolet rays "dry" it, reducing virulence. Those bacteria that do not die under the action of ultraviolet rays are not pathogenic enough for infection. You need a direct hit to contract tuberculosis. enough virulent bacteria into the air we breathe.

If you are walking outside, it is worth avoiding getting the sputum of people who may have tuberculosis directly into the air you breathe, and this will be enough.

But in public transport there are all conditions for infection:

1. Large crowd of people.
2. Bad ventilation.
3. Moist warm air.

Therefore, you should be careful about coughing in public transport and remember that small aerosol particles (up to 5 microns in diameter) containing mycobacteria spread over several meters and remain in suspension for up to 1 hour.

What can you get from TBC?

In everyday life, the likelihood of TBC infection from a sick person is very high, since the mycobacteria secreted by him are in the air, they can settle on food and household items, increasing the risk.

To avoid infection, you must follow these rules:

1. A patient with tuberculosis should have his own personal hygiene items, his own dishes.
2. For the patient it is necessary to allocate a separate room.
3. Wet cleaning (at least twice a day) and ventilation should be organized in the room. Windows should face the sunny side.

Patients who are bacterial excretors should undergo special treatment in the TB dispensary. This will protect others from infection and speed up the recovery of the patient.

At-risk groups

There are several groups of people who have a higher chance of infection:

1. Persons in contact with patients.
2. Persons with residual changes after tuberculosis.
3. Patients with diabetes mellitus, pneumoconiosis, peptic ulcer stomach and duodenum.
4. Patients with immunodeficiency.
5. Smokers.
6. Persons in places of detention.
7. Asocial strata of the population.

In the video you can find answers to questions about tuberculosis:

Doctor: high risk.

Also worth highlighting special group risk: these are doctors and medical staff who are in regular contact with TB patients. To avoid disease, it is necessary to use individual means protection, such as special respirators, goggles when performing manipulations associated with a risk to unprotected mucous membranes and inhaled air.

An important component in the work is ... nutrition. If mycobacterium enters an empty stomach, it can invade the mucosa, thus increasing the risk of developing the disease. When MBT enters the stomach, which has contents, the bacterium is simply digested in the gastrointestinal tract.

It is necessary to remember about the hygienic treatment of hands and tools after contact with patients with disinfectant solutions (see). The uniform in which the doctor works with patients must be handled and not used in contact with healthy people.

How to avoid infection?

Individuals with reduced immunity are primarily at risk of contracting tuberculosis, therefore great attention focus on lifestyle and health issues. Special meaning worth paying proper nutrition, timely treatment diseases, as well as issues of immunoprophylaxis.

Vaccination promotes the development of immunity and reduces the risk of morbidity after primary infection.

Diagnosis of tuberculosis:

1. Tuberculin diagnostics: carrying out a test with tuberculin allows you to identify the lack of immunity in children or already occurring infection with mycobacterium.
2. Diaskintest: allows you to clearly determine the presence of an active tuberculosis process in the body, based on the reaction of specific MBT proteins.
3. Fluorography: conducting an annual preventive fluorographic study allows you to identify changes in the lungs that are characteristic of the tuberculous process and prevent the development of destructive forms of pathology with bacterial excretion.

Conclusion

There is always a risk of contracting tuberculosis. To avoid infection, it is necessary to healthy lifestyle life, eat right, apply for medical care and follow the instructions of the experts. Be healthy!

Judging by nutrition, you absolutely do not care about immunity and your body. You are very susceptible to diseases of the lungs and other organs! It's time to love yourself and start getting better. It is urgent to adjust your diet, to minimize fatty, floury, sweet and alcohol. Eat more vegetables and fruits, dairy products. Feed the body with the intake of vitamins, drink more water (precisely purified, mineral). Harden the body and reduce the amount of stress in life.

Spring is in the yard, the snow has melted, winter is gone, but the infection remains. Usually tuberculosis is especially active at this time. Many are sure that they get sick somewhere "at the bottom", outside normal life. Alas, this delusion is the main and not the only one.

To clarify the rest is vital important points regarding the illness, we turned to Valentina Aksenova, the head of the children's phthisiatrician of the Ministry of Health and Social Development of Russia, head of the pediatric and adolescent department of the Research Institute of Phthisiopulmonology of the 1st Moscow State Medical University named after I.I. Sechenov.

So, here important facts about this dangerous disease and rules to help you avoid it:

Passed like a cold

1. There are two opposing opinions among the people about how easy it is to get infected with tuberculosis: some are sure that this is a super-contagious disease, others that if a tuberculosis patient does not cough in your face, there is nothing to be afraid of. The truth, as usual, is out there somewhere. Tuberculosis is indeed very contagious, transmitted in the same way as respiratory viruses- airborne. Further, it all depends on how close the contact with the patient is (as well as on the form of tuberculosis - open or closed), and on the state of your body. If it is weakened, the risk of getting sick after exposure to infection is higher. At its peak, it is in people with immunodeficiencies - for example, in those who are infected. How are thingsthe case of the bulk of Russians, it is clear from the statistics: in Russia, about 90 percent of people are infected with tuberculosis, but only 1 percent suffer from it.

Where there are people, there is infection

2. Tuberculosis can be contracted anywhere - this is not an exaggeration. Including in transport. Including the elevator. Including at work, in the store, at the station. In other words, in any public place. And the risk of infection through the handrails on a bus or subway, which is traditionally feared, is quite real if a patient with tuberculosis sneezes on them, followed by a passenger with a weakened immune system, after which he rubs his nose with the same hand, for example.

Wash your hands before eating

3. And what to do in such a situation? Sitting locked up and afraid of every sneeze? There is a set of measures that reduces both the risk of infection with tuberculosis and the development of the disease itself. The latter concerns vaccination (the same one that is carried out in the maternity hospital) - it does not provide 100% protection, but it provides protection against severe forms tuberculosis. Next - lifestyle and nutrition: the menu should include meat, fish, dairy products - protein contributes to the body's resistance to tuberculosis. It goes without saying that since the risk of infection occurs in in public places, you should at least wash your hands after visiting them, and besides, in the same transport it is better not to touch your eyes, mouth and do not rub your nose with your fingers. If someone is coughing nearby, try to hold your breath.

Who is at risk:

People who are in close contact with patients (family members, for example)

Uninfected people under 30 years of age (risk decreases with age)

Those with chronic lung disease diabetes, for a long time taking hormonal drugs

smokers

Medical workers

Colony workers, prisoners

Homeless

Important!

There is special examinations relating specifically to the detection of tuberculosis: in children, this is a reaction to tuberculin - a test Mantoux, in people at risk - diaskintest (a similar, but more sensitive test), a universal option for adults - fluorography, which is traditionally supposed to be done once a year.

Tuberculosis - infection caused by mycobacteria and is predominantly transmitted by air. It is characterized inflammatory process with subsequent disintegration in the affected organs, severe intoxication of the body as a whole and a particularly long course. The incidence of tuberculosis in the world began to rise again from the beginning of the 90s. 20th century

Who has tuberculosis

Every year, 8-9 million people fall ill with tuberculosis and 2-3 million die from complications of this disease. It is generally accepted that tuberculosis is a disease of low-income people living in unsanitary conditions. In fact, no one is immune from this disease - people of absolutely all ages and social status in society.

The causative agent of tuberculosis

The causative agents of this disease in humans are mycobacteria of two types, human and bovine (the latter develops in people living in countryside and eat animal products infected with the bacterium).

How infection occurs

Due to the high prevalence of mycobacteria (a third of people on Earth are infected with them), it can be said with certainty that tuberculosis pathogens are in the air in all crowded places, for example, in public transport. But respiratory system A healthy person is protected from the penetration of a microbe by special mechanisms, therefore, in the vast majority of cases, infection does not occur. If a person is weakened, if he suffers from acute or chronic diseases of the respiratory tract, then the defense mechanisms may fail, and mycobacterium takes root in the body.

Development of the disease

When mycobacteria enter the body, the immune system enters the fight against them. Further development events depends on its state. If the immune system is working properly, it will stop Mycobacterium tuberculosis from multiplying. Some of them will still remain in the body in a "sleeping" state. The presence of a tuberculosis infection in a person in the absence of signs of the disease itself is not tuberculosis. Such carriers of tubercle bacilli are not contagious to other people. If a person's immunity is significantly weakened, mycobacterium tuberculosis continues to multiply in the body, and after a while tuberculosis develops.

Symptoms of pulmonary tuberculosis

In most cases, it is the lungs that are primarily affected, and from them the infection with the blood flow enters other organs. The insidiousness of this disease is that pulmonary tuberculosis often proceeds without symptoms for a long time, and it is discovered quite by accident, for example, during fluorography. The first symptoms of the disease are signs general intoxication body:

• weakness, lethargy;
• dizziness;
• poor appetite;
• apathy;
• bad sleep;
• night sweats;
• pallor;
• weight loss
• subfebrile (about 37 degrees) body temperature.

There is an increase in one or more groups of lymph nodes. If you do not start treatment at this stage, complaints from one or another organ join the above. In the case of lung damage, these are: cough with or without sputum; shortness of breath pain in chest when coughing or at rest; excretion of blood with sputum.

The sooner a disease is detected, the more effectively it can be treated. Untimely appeal to doctors leads to the progression of the disease. In addition, the patient also becomes a source of infection for people who communicate with him. Advanced forms of the disease are difficult to cure even with the help of modern medicines.

At-risk groups

• Persons who have been in contact with a patient with active tuberculosis who releases Mycobacterium tuberculosis into the air
• Children and adolescents suffering chronic diseases that lower the immune system
• Persons who use alcohol in excessive quantities, drugs, smoke, eat poorly, are in stressful situations and adverse environmental conditions
• faces, virus-infected human immunodeficiency; 60% of AIDS patients die from tuberculosis.

How to protect yourself from tuberculosis

To protect yourself from the danger of infection, you should lead a healthy lifestyle. You need to take care of your health: eat right, exercise, exercise, temper, observe personal hygiene, go to fresh air, consult a doctor in a timely manner if symptoms of any disease appear.

Remember the main thing: it is not important whether Mycobacterium tuberculosis enters your body or not, but how the body meets it. "A bacterium is nothing, the environment is everything" - this is the conclusion of Louis Pasteur, the discoverer of the microbial essence of many diseases. So, a healthy lifestyle, careful attitude to your body and an adequate immune response (which is primarily achieved by vaccination) are a guarantee that even if you inhale the causative agent of tuberculosis, it will not stay with you forever.

Tuberculosis is an infectious disease. A person becomes infected by airborne droplets in transport, in the cinema, in a store, especially since more than 10 cubic meters of air passes through the lungs per day. This disease is not at all a complication of pneumonia and cannot develop from an undertreated acute respiratory disease, as some mistakenly think.

This infection is caused by specific bacteria - Mycobacterium tuberculosis, otherwise they are called Koch's sticks. After you inhale them, they spread throughout the body with the flow of lymph and blood, therefore they can affect any organ that is well supplied with blood, most often the lungs.

A person from whom an infection can be caught does not necessarily look frail, choking from a cough, and this is not necessarily an antisocial person. It could be a colleague, a neighbor, a family member. Patients usually do not themselves know about their danger to others, and cough is attributed, for example, to asthma, allergies or residual bronchitis, smoking.

When you catch a mycobacterium for the first time, you are considered infected. Do not confuse this with the concept of "illness". Infection is a condition in which mycobacteria are silent in the body, but do not cause disease. And already the disease is tuberculosis, this is when mycobacteria began to multiply uncontrollably, because the immune system cannot cope with them. At the same time, in the early stages of the disease, a person does not release mycobacteria into the external environment.

In our country, the situation with tuberculosis is as follows: by the age of 18, 8 out of 10 people are infected, and in 5–10% of them, the carriage of the Koch bacillus turns into active tuberculosis. It turns out that by adulthood, most people are already infected, nothing can be done. It remains to intercept the onset of the disease in time, to catch the first changes in the lungs, if they begin. This can only be done with the help of fluorography, repeating it once a year.

Fluorography is the first study that is needed if you have suspicious symptoms: cough, shortness of breath of any intensity or subfebrile temperature(about 37.5°) lasting longer than three weeks. Especially if it is accompanied by fatigue, increased fatigue, sweating in the morning. Unfortunately, TB in other organs, such as genital TB or kidney TB, cannot be detected with this screening test. It can be suspected only when obvious symptoms appear.

If the phthisiatrician does not like the result of the fluorogram, he prescribes an additional x-ray of the lungs and tomographic studies, a triple sputum analysis. The Mantoux test is also prescribed, but for adults it is used only as additional method examination and is interpreted quite differently than in children. You can additionally do Diaskintest - an alternative to the Mantoux test. This is the latest tuberculosis allergy test, similar in technique to the Mantoux test, but more sensitive.

About, How easy is it to get TB?, there are two opposing opinions among the people: some are sure that this is a super-contagious disease, others - that if a tuberculosis patient does not cough in your face, there is nothing to be afraid of. The truth, as usual, is out there somewhere. Tuberculosis is indeed very contagious, transmitted in the same way as respiratory viruses - by airborne droplets. Further, everything depends on how close the contact with the patient is, as well as on the form of tuberculosis - open or closed, and on the state of your body. If it is weakened, the risk of getting sick after contact with the infection is higher. At its peak, it is in people with immunodeficiencies - for example, in those who are infected. It is clear from the statistics how things are for the bulk of Russians: in Russia, about 90 percent of people are infected with tuberculosis, but only 1 percent suffer from it.

Tuberculosis can be transmitted anywhere- this is not an exaggeration. Including in transport. Including the elevator. Including at work, in the store, at the station. In other words, in any public place. And the risk of infection through the handrails on a bus or subway, which is traditionally feared, is quite real if a patient with tuberculosis sneezes on them, followed by a passenger with a weakened immune system, after which he rubs his nose with the same hand, for example. Wash your hands not only before eating.

There is a set of measures that reduces both the risk of infection with tuberculosis and the development of the disease itself. The latter concerns vaccination (the same one that is carried out in the maternity hospital) - it does not provide 100% protection, but it does provide protection against severe forms of tuberculosis. Next - lifestyle and nutrition: the menu should include meat, fish, dairy products - protein contributes to the body's resistance to tuberculosis. It goes without saying that since the risk of infection occurs in public places, you should at least wash your hands after visiting them, and in addition, in the same transport, it is better not to touch your eyes, mouth or rub your nose with your fingers. If someone is coughing nearby, try to turn away.

It should be borne in mind that to become infected with tuberculosis from another person, it is necessary to contact him long time. According to the theory, in order to get infected from a sick person with an active form of infection, it is necessary to communicate with him for 8 hours a day for 6 months or be with a patient with tuberculosis in the same room 24 hours a day for 2 months. With a single meeting at close range, the likelihood of infection entering the healthy body very small. In the event that the patient has undergone a two-week course of treatment, then the possibility of infection from him is close to zero.

• People with impaired health
• Individuals subject to drug and alcohol addiction can become infected with tuberculosis
• Those who live in adverse conditions
• Individuals treated with drugs that weaken the immune system can become infected with tuberculosis
• Can people who take steroids get TB?
• diabetics
• Elderly women and men

If you are one of the listed items and think that one of your loved ones may have tuberculosis, then seek the advice of a doctor and use prevention methods:

• Ventilate the room several times a day. Together with not fresh air, microbes, including causative agents of tuberculosis, also disappear.
• If you think that one of your loved ones is sick with tuberculosis, then strongly advise him to go to the doctor for examination and, if necessary, receive treatment.
• Wear protective masks if you work in the same room as a TB patient, or better, convince the patient to wear a mask.
• To avoid contracting tuberculosis, spend less time in poorly ventilated, stuffy room in which the person-carrier is constantly located active form tuberculosis.
• Before coming into contact with a person with this disease, make sure that he has undergone a minimum two-week course of treatment.

Tuberculosis symptoms. The most common form of this disease is pulmonary. Symptoms of tuberculosis include: night sweats, shortness of breath, cough (dry or with sputum or blood in the sputum), lack of appetite, weight loss, headache, constantly fever(about 38C°). In addition, there may be a decrease in efficiency, irritability and mood swings. On the initial stages diseases, only 2-3 symptoms may appear, and among them there will not necessarily be a cough. If at least one of the above symptoms occurs, you should immediately consult a doctor and in no case be treated on your own.

If taken medicine independently, Koch's sticks produce defense mechanisms on the drug and in the future, it becomes much more difficult to treat the disease. Treatment of drug-sensitive tuberculosis lasts about six months, and sometimes it takes up to 2 years to fight the disease. The therapy is carried out systematically, without the slightest pause. This is necessary so that the infection cannot recover. To cure tuberculosis in a patient, he is placed on hospital treatment. After 2 months, the patient is transferred to ambulatory treatment, but provided that there are no pathogens in the human sputum that pose a threat to others.

No wonder they say that all diseases are caused by stress.. Stress is the main cause of disease in the socially prosperous population. It would seem that a person goes in for sports, eats normally, has a relatively high income, and follows the rules of hygiene. And suddenly the diagnosis is tuberculosis. When questioning the patient, it turns out that he was under the influence stressful situation- from morning until late at night trying to earn money, experiencing discomfort or psychological pressure at work, or divorced his other half.

Or everything is great at work, but, running out in the morning, a person drinks a cup of tea or coffee, has a sandwich instead of lunch, and has a hearty dinner in the evening. It is also stressful for the body. As a result, when a tubercle bacillus enters the body, the production of protective cells there is neither building material nor enough energy. And in recent times, the number of patients of the dispensary is replenished by young girls striving for harmony and “sitting” on strict diets.

Tuberculosis is a disease of socially disadvantaged segments of the population. This is not entirely true. Tuberculosis is an airborne infection. Protecting yourself from tuberculosis is almost impossible, and doctors talk about it at every opportunity. It is only possible to reduce the risk of the disease. Ultimately, sustainability plays a decisive role. immune system person. Statistics show that more than 95% of TB patients are smokers. Smoking kills the first barrier on the way of tubercle bacillus into the body. This is the protective system of the bronchi. Further, when the tubercle bacillus has already penetrated into the lymphatic and circulatory system, significant defensive forces body to localize the focus of the disease. But not everyone has these powers.

Unfortunately, there is a law on involuntary hospitalization for tuberculosis, but it is very formal. There are no closed TB facilities. As much as we would not like it, but a socially maladaptive person can leave the walls at any moment. medical institution and move freely among healthy people by infecting them. But these are those who know about the disease. There is a whole layer of asocial people whom medicine is not even able to cover with diagnostics, due to their indifference to the health of their own and those around them.

Tuberculosis is terrible because in the initial stages it is almost asymptomatic.. Often, the patient initially feels great and refuses to believe the doctors when he is given a diagnosis. The classic manifestations of tuberculosis, such as coughing, blood on coughing, heat, weight loss - these are signs of deep running process. Often at this stage, the question is already about the disability or the patient's life itself. Fluorographic examination and special clinical tests- bye the only way identify the disease early stage. The earlier the disease is detected, the greater the chances for a more stable remission and final recovery without consequences.

Tuberculosis is a disease of cities, rural residents get sick less often. Unfortunately, it is not. Although the air in the villages is cleaner and natural nutrition but there are other risk factors. As a rule, rural residents are more open and sociable, they have more low level income, and often there is no opportunity for employment. Unfortunately, it should be noted that in the modern village there are yards where households are simply not kept. Sometimes they just have nothing to eat, let alone good nutrition. Do not write off smoking and alcohol abuse. If you take absolute numbers sick people, indeed, it seems that in the villages they get sick less. However, when recalculating the number of patients per 10 thousand people, it turns out that the incidence is higher in rural areas.

dog meat and badger fat not a panacea for tuberculosis. The delusion probably comes from communication with the peoples of the north. At one time, tuberculosis became widespread among them. In the absence of anti-tuberculosis drugs, people sought additional sources squirrel. After all, the cells that fight tuberculosis are of a protein structure. Dog meat was eaten as one of the options diet food. However, the legend of healing properties dog meat has taken root among the people. Although she remains a legend. Representatives of Asian peoples, in whose cuisine the use of dog meat is traditionally accepted, do not become healthier, they also get sick. The basis of the diet of a patient with tuberculosis must include protein products- milk, eggs, fish and any meat.

Even Chinese medicine only treat tuberculosis chemicals. The reason is that there is not a single remedy, even among heavy poisons, that would kill tubercle bacillus. She is very stable. For the past 25 years, world pharmacology has not invented new drugs to combat Koch's wand. That's why folk remedies can be used in parallel with chemotherapy, but do not replace it.

A doctor who respects himself and the patient will never say that the treatment of tuberculosis is absolutely harmless. To date, there is not a single chemical production drug that does not have side effects, including vitamins. Even after overdosing on the relatively safe aspirin, a person can die. You can get poisoned by anything, the whole question is correct dosage. The specialist prescribing treatment bears legal and moral responsibility to the patient. The doctor draws up a treatment plan based on the patient's condition. He is armed with knowledge and experience, is well acquainted with side effects drugs and knows how to neutralize them. Treatment begins with a discussion of lifestyle, diet, and frequency of meals. Examination is carried out, contraindications are revealed.

Tuberculosis is curable. Tuberculosis is treated just like any other disease. If doctors cannot cure him therapeutically, with drugs, then there is the possibility of referral to surgery sick. Everything rests only on the desire of the patient himself to be cured.

Treatment always consists of two stages - the phase intensive care(minimum 90 days) and continuation phases (minimum 120 days). The earlier the tuberculosis process is detected, the less likely that there is bacterial excretion, and the shorter the treatment time will be, and perhaps you won’t even have to be hospitalized. Although it is advisable to start treatment in a hospital - the drugs are serious.

There are doubtful situations when it is difficult to understand whether you have tuberculosis or another disease, such as oncology. Know that your destiny is not in the hands of one doctor, even in the hands of one dispensary. The conclusion is issued by a commission of at least three experts. In the same way, a decision is made to transfer to a day hospital or to home treatment without fear that the patient will develop adverse reactions for medicines. The set of drugs is individual, the sensitivity of your mycobacteria to them is always checked. Pills are not handed out, as some people secretly stop therapy.

Tuberculosis is curable if you start on time, do not interrupt therapy, do not self-medicate. Passes official medicines and playing self-taught doctor lead to the emergence of resistant microbes that are difficult to treat with antibiotics. And the treatment is much longer and more expensive.

Good nutrition, walks in the fresh air, stopping smoking and alcohol abuse, eliminating stress are reliable helpers in the prevention or cure of tuberculosis.