Is it possible to catch tuberculosis by pricking a finger with a needle. Contact with a patient with tuberculosis - what is the risk of infection? The closed form of tuberculosis has two stages

Tuberculosis is an infectious-inflammatory disease that is caused, otherwise Koch's wand (named for the scientist Robert Koch, who made the discovery). Among all cases of diagnosed tuberculosis, only 10% are accounted for. In most patients, it proceeds in a closed form, which is less dangerous, but also requires inpatient treatment with antibiotics under the constant supervision of a phthisiatrician.

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Stages of development of tuberculosis

Tuberculosis goes through several stages in its development. The first one is infection. This period begins from the moment the first Koch bacillus is transmitted from the carrier to a healthy person, and lasts until an immune response is formed.

A feature of mycobacteria M. tuberculosis is that they do not produce specific toxins. This makes it difficult for the immune system to recognize the "invader". If phagocytosis is started with a critical delay, infection turns into a disease. The multiplied bacteria are carried with the lymph flow throughout the body and begin pathogenic activity.

Having settled on the internal organs, Koch's wand creates a focus of specific "cold" inflammation, which is covered with a hard "dome" of protective connective tissue -. Hence the name of the disease (Latin tuberculum - tubercle). Formations are prone to growth, and in the absence of therapy, they affect large areas of organs, causing their decay. In this case, the bacteria are carried outside the affected area, they can be found in all the physiological secretions of the patient - saliva, sputum, urine, feces, etc.

This form of tuberculosis is called open. Compared to the closed one, it poses a great danger to humans, but it is curable in the early stages of diagnosis and with timely therapy.

What is a closed form of tuberculosis?

If the immune system does not cope with the pathogens, but keeps them under control, an infected person develops a closed, or inactive, form of tuberculosis.

In this case, the pathogenic microflora is present in the body, but does not conduct activity, being in a "sleeping" state. Mycobacteria almost do not move, but their activity can begin under favorable circumstances for the development of the disease.

The closed form of tuberculosis has two stages:

1 stage - Koch's wand, settling on the walls of organs, forms fibrous capsules, but due to the low activity of the pathogen, healthy tissue is not destroyed. The tubercles quickly overgrow, leaving behind a seal;

2 stage - Bacteria enter the bloodstream and form multiple lesions. Penetrating into the lungs, M. tuberculosis cause.

The further pathogenesis of the closed form of the disease depends on many factors: the presence of aggravating circumstances, the number of pathogens, their aggressiveness, congenital and / or acquired resistance to M. tuberculosis, etc. Possible scenarios are as follows: either the body eliminates foreign microorganisms, forming a stable immunity, or the closed form will flow into the open one.

Symptoms of the closed form of tuberculosis

The danger of a closed form of tuberculosis, among other things, is that there is no pronounced clinical picture of the disease. An infected person is concerned about increased fatigue, occasionally dizziness. A patient with a closed form of pulmonary tuberculosis has symptoms such as:

Slight difficulty breathing;
short-term bouts of dry cough;
mild chest pain.

At stage 2 of the closed form, the following symptoms are added:

A short rise in temperature to subfebrile values (especially in the evenings);
severe pain behind the sternum, caused by pleurisy.

Ways of transmission of infection with a closed form of tuberculosis

Tuberculosis is transmitted in several ways:

Airborne - when particles of saliva or sputum of an infected person are inhaled, which are dispersed into the air when coughing, sneezing or talking;
alimentary - bacteria are transmitted by ingestion and absorbed through the walls of the digestive tract;
contact - Koch's wand is transmitted through the skin and mucous membranes;
intrauterine - infection of the fetus by the mother through the placenta.

To answer the question of how the closed form of tuberculosis is transmitted and whether it is transmitted at all, you should know: in the natural secretions of a person with a closed form of tuberculosis, Koch's bacillus is absent, therefore he is a carrier of the disease, but not its carrier.

What is the risk of infection with a closed form?

The probability of contracting tuberculosis, even with prolonged and close (including sexual) contact with a person with a closed form of the disease, tends to zero. Official medicine leaves her no more than 0.1% of all infections.

This applies to stage 1 of the disease. At stage 2, when mycobacteria have already entered the bloodstream, the infection is transmitted by accidental contact of blood with the mucous membranes, lungs or esophagus of a healthy person.

The problem of how closed tuberculosis is transmitted is complicated by the thin line between forms of the disease: it is not always easy to trace it.

The awakening of microorganisms contributes to weakened immunity, which occurs due to:

Prolonged stress;
malnutrition;
chronic prolonged lack of sleep;
alcohol abuse;
smoking;
concomitant chronic and / or acute diseases;

In addition, children and pensioners are at risk, to whom the disease is transmitted especially easily. Also, closed tuberculosis is transmitted faster in stuffy rooms.

Under unfavorable circumstances, M. tuberculosis become active. From this point on, the closed form of tuberculosis becomes open, and the infection is transmitted even with short-term contact.

Diagnostic methods

If a closed form of tuberculosis is suspected, it is necessary to immediately see a specialist in diseases of the tuberculosis group - a phthisiatrician.

He will prescribe a set of laboratory tests and hardware examinations, which, with a closed form of tuberculosis, show the following:

Tuberculin test () - positive;
– positive;
– positive;
sputum test for M. tuberculosis – negative;
radiography - without pathological changes in internal organs.

Treatment of the disease

Despite the fact that tuberculosis of the closed form is not transmitted, therefore, it is not a socially dangerous disease, a person with this diagnosis is placed in a specialized medical institution - an anti-tuberculosis dispensary. Such measures are fixed at the legislative level. If the patient refuses to be observed in the hospital, law enforcement officers can deliver him forcibly.

In the dispensary, the patient is treated with medication. In this case, Tubazid (isoniazid) and Rifampicin (or another antibiotic from the rifamycin group) are used. Depending on the development of the disease, courses of various durations are prescribed, for example:

Subject to positive dynamics, the patient can be allowed to go home on weekends or on weekdays. After the end of therapy, he remains registered in the dispensary for some time.

The prognosis of the closed form of the disease in most cases is favorable. However, even with a complete cure, the likelihood of re-infection remains.

Prevention measures

Active prevention of tuberculosis in Russia is carried out at the state level. With the consent of the parents, in the first few days after birth, each child in the maternity hospital is given. It contains a weakened strain of bovine TB that does not cause infection but is active enough to elicit an immune response.

Active prevention includes:

For kids – annual Mantoux test;

for adults - Fluorography at least once every 2 years.

Passive preventive measures are those that are aimed at strengthening immunity:

Taking multivitamins;
proper nutrition;
healthy lifestyle;
sports;
hardening;
frequent ventilation of enclosed spaces.

A person can be a carrier of Koch's wand for more than one year, but not have tuberculosis. Reasons for the development of the disease and preventive measures.

664 04/18/2019 6 min.

The cause of tuberculosis is tuberculosis bacteria or Koch's bacilli. They are spread by airborne droplets. When bacteria from a sick person gets into the air, when coughing, talking or sneezing, they can get into the respiratory tract of people nearby.

You can get tuberculosis if a person is in poor physical shape, has lost a lot of weight, or has HIV.

In this article, we will tell you about the types of tuberculosis, how the bacteria spread, as well as possible complications and methods of prevention.

Disease Definition

Tuberculosis is a common infectious disease caused by mycobacterium tuberculosis (Koch's bacillus). Its prevalence among the population has a direct relationship with socio-economic conditions. For example, in countries where it is not possible to provide a high level of immunoprophylaxis or early diagnosis, and where a large part of the population lives in poor conditions, is malnourished and does not receive normal care from doctors, the incidence rate is increasing.

According to statistics, about nine million people fall ill with tuberculosis every year, and about three million people die from complications.

If there is a decrease in general and local immunity, then Mycobacterium tuberculosis is activated, resulting in the development of one of the clinical forms of the disease. The probability of occurrence of the disease is also determined by the number of mycobacteria that have entered the human body.

Based on this, several risk groups for tuberculosis are distinguished:

People who live and stay in the same room with a patient with tuberculosis for a long time.
Persons suffering.
Smokers, alcoholics, drug addicts.
HIV-infected.
People taking drugs that suppress the immune system.
Medical and social workers, employees of places of deprivation of liberty.
People with immunodeficiencies.
Prisoners.
Patients with diabetes.
People who already had tuberculosis.
Persons without a fixed place of residence.
Patients in psychiatric hospitals.

Symptoms vary depending on the type of tuberculosis. Consider the most striking symptoms, the appearance of which you need to see a doctor:

Persistent cough or cough.
Throwing blood.
Prolonged subfebrile temperature (not higher than thirty-eight degrees).
Sweating at night.
Constant malaise and fatigue.
Pain in the chest that is aggravated by coughing.
Breathlessness.
Weight loss.
Enlarged lymph nodes.

Kinds

With tuberculosis, the patient's status changes depending on the stage of the disease and on the effectiveness of treatment. It can be open and closed.

With an open form, a sick person releases mycobacteria into the environment. The open form is characteristic of pulmonary tuberculosis, when microbes are released during coughing and expectoration of sputum. It is also called BK+. This means that during the microscopic examination of a sputum smear, the bacteria that cause tuberculosis were found.

The closed form of tuberculosis is diagnosed much more often. It is designated as BK-. This means that the patient does not release Koch's sticks into the air. The disease destroys cells rather slowly, while remaining almost immobile. The infection constantly changes from active to inactive and back, so it is difficult to treat the closed form of tuberculosis.

Tuberculosis is either primary or secondary. In primary tuberculosis, which usually occurs in childhood, symptoms do not appear for several days or even weeks.

Secondary tuberculosis is a more common form of lung disease. It occurs due to the fact that in the old foci, there is still an infection. When creating favorable conditions for pathogens, they are activated and exacerbate the disease. Secondary tuberculosis can develop at any age.

Treatment of secondary tuberculosis should be long-term. This is the only way to prevent serious irreversible damage occurring in the lungs.

Secondary tuberculosis has several forms-stages:

Tuberculoma.
Caseous pneumonia.
Cavernous.
Cirrhotic.

Other types of tuberculosis:

Tuberculosis of the intrathoracic lymph nodes. This is one of the most common forms of primary tuberculosis. When the lymph nodes increase, the tracheobronchial tree is compressed, and local changes develop.
disseminated pulmonary tuberculosis. It rarely occurs. Usually disseminated tuberculosis occurs in acute or subacute forms. The disease develops due to the extensive hematogenous spread of tuberculosis infection.
Tuberculosis of the genitourinary system. This disease is the most common type of extrapulmonary tuberculosis. In this case, kidney damage occurs.
Tuberculosis of joints, bones. It develops mainly in children in the first three years after infection, and in most cases the middle sections of the spine are affected.
tuberculous meningitis. This form is rare and has a poor prognosis. Without qualified treatment, tuberculous meningitis can be fatal.
miliary tuberculosis. With this form of the disease, the pathogen spreads through the blood. Because of this, small lesions - granulomas - form in different organs and tissues.

Spreading

The most common way tuberculosis is spread is by airborne droplets. At the same time, the smallest droplets of sputum, which contain Mycobacterium tuberculosis, enter the lungs.

The most dangerous are sick people with massive bacterial excretion, who, even when talking, emit infected sputum droplets. The spread of the aerosol also occurs with a strong cough, sneezing, loud conversation.

Atomized aerosol (particles up to five micrometers in size) can remain in the air of an enclosed space for up to one hour, after which it settles on everything around. Infection is easiest in poorly ventilated enclosed spaces.

Infection by airborne dust occurs by inhalation of dust particles with mycobacteria included in them.

You can also get infected with tuberculosis through the alimentary route. This occurs when eating contaminated products. You can become infected through milk and dairy products, less often through meat or through direct contact with animals.

The contact route of infection is infection through the skin and mucous membranes. Thus, those who work with the culture of mycobacterium tuberculosis or infectious material, as well as livestock workers in contact with sick animals, can become infected.

Intrauterine infection is very rare. You can become infected when the placental barrier is broken or as a result of ingestion of amniotic fluid containing mycobacteria.

Incubation period

The incubation period of tuberculosis is the period from the moment when Mycobacterium tuberculosis enters the body until the first symptoms appear. It lasts from three to twelve months and even more.

It is difficult to identify the end of the incubation period, since the onset of the disease is confused with a respiratory viral infection.

During this period, Mycobacterium tuberculosis, entering the respiratory tract, are exposed to the immune system. When the immune system is strong enough, the mycobacterium dies and tuberculosis does not develop. But if the immune system is weak, then the mycobacterium that has got inside penetrates the lungs and provokes the development of an inflammation focus.

It should be remembered that during the incubation period, a person does not excrete mycobacteria. At this tapa, the Mantoux test will be negative.

Complications in the absence of treatment

Complications of tuberculosis include:

Hemoptysis. Sputum with streaks of blood or blood-stained sputum up to fifty milliliters per day is allocated.
Pulmonary bleeding. Scarlet foamy blood is released from the respiratory tract when coughing more than fifty milliliters per day.
Pneumothorax. There is an accumulation of gas in the pleural cavity, due to which the lung tissue subsides, the mediastinum is displaced, the blood vessels of the mediastinum are compressed, and the dome of the diaphragm descends. As a result, respiratory and circulatory disorders develop.
Cardiopulmonary failure. It is accompanied by shortness of breath, tachycardia, pain in the region of the heart, peripheral edema, hepatomegaly, blue skin, swelling of the veins of the neck.

Modern methods of prevention (vaccination and drugs)

Prevention of tuberculosis includes the following methods:

Social prevention. It is aimed at improving the environmental conditions, improving the material well-being of the population, improving nutrition and housing conditions, taking measures to combat alcoholism, drug addiction, and so on.
Sanitary prevention. It is needed to prevent infection of healthy people. Social, anti-epidemic and therapeutic measures are being taken in the focus of tuberculosis infection.
Specific prophylaxis. This includes vaccination and BCG revaccination. For vaccination, a BCG strain is used, which multiplies to a limited extent in the lymph nodes. For prophylaxis, a dry BCG vaccine is used.

In healthy people, vaccination and revaccination of BCG does not affect well-being.

Chemoprophylaxis. Anti-tuberculosis drugs are used to prevent tuberculosis in those most at risk of infection. Drugs such as or Ftivazid are used for three months.

Video

conclusions

Anyone can get tuberculosis, regardless of social status, place of residence and other conditions. You can protect yourself from the disease if you take care of your health, improve living conditions, eat well, undergo fluorography in a timely manner, do a Mantoux test and BCG vaccinations.

Tuberculosis is a deadly disease. It has been killing people for thousands of years. Despite the development of medicine, the creation of vaccines, the risk of infection with Koch's bacillus remains quite high in many countries today. To reduce the likelihood of infection, it is necessary to understand how infection occurs, how tuberculosis is transmitted from person to person.

Who is at risk

A person with an active form of the disease, when coughing, sneezing, releases a large number of mycobacteria into the environment. They not only hover in the air, but also settle on various objects, mix with dust. Then they end up in the respiratory tract of healthy people. The highest probability of infection with Koch's wand is with a weakened immune system.

Tuberculosis risk groups:

Pregnant and lactating women. Due to the ongoing hormonal changes, the defenses weaken, making the body more vulnerable to many diseases.
Young children whose immune systems are not yet fully developed to fight infection. The likelihood of infection increases due to the lack of hygiene skills in babies.
A patient in a hospital ward undergoing treatment.
Soldiers living in the barracks.
Prisoners in overcrowded cells with no air circulation.
Children attending preschool and school if a person with an active form of the disease works there.
Family members where the patient lives.

Residents of large cities should be especially concerned about their health. Infection with tuberculosis is not excluded in public transport, on the landing. The source of the disease can be found everywhere. Whether or not infection occurs depends on the state of the immune defense. The danger is the latent course of the disease, when at any moment it can manifest itself. In addition, the spread of infection is very fast.

The main source of the disease

Koch's wand, which is one of the main causes of tuberculosis, was discovered many years ago. But so far it has not been completely defeated. The reason is the protection of mycobacteria and its ability to quickly adapt to new conditions.

How long is the viability of mycobacteria in the external environment e

Being on household items, Koch's wand can exist up to 3 weeks. In water and soil, it is able to live for six months. The life of the pathogen in apartment conditions with suitable humidity is 7 years. Mycobacteria are contained in the sputum secreted by tuberculosis patients, where their vital activity persists for almost 12 months. Street dust keeps Koch's wand for 2 months.

What is the causative agent of tuberculosis afraid of?

Mycobacteria (causes of the disease) do not tolerate ultraviolet radiation. To destroy the bacillus of developing tuberculosis with a bactericidal lamp is a matter of 2 minutes. To be in direct sunlight, to achieve this result, you need 2 hours. After a maximum of half an hour, Koch's stick dies in the process of boiling. Disinfectants cope with it in 6 hours.

Ways of infection

According to statistics, more than 8 million cases of tuberculosis are registered every year. This suggests that infection can happen to anyone. Knowing how you can get TB increases your chances of avoiding the disease. The risk increases with close contact with a person who releases mycobacteria into the environment. Extrapulmonary forms are less dangerous. You should know that the disease is not inherited.

The main ways of infection with tuberculosis:

Airborne. This is one of the most common ways of getting infected. The main lungs are mycobacteria that enter the body when inhaled. Especially often there is an infection with tuberculosis by airborne droplets from a patient with an open form when he is in a cramped room with him.
Contact household. Pulmonary tuberculosis is widespread, transmitted through the use of common objects - dishes, towels. Many cases are known of how they become infected sexually (genital tuberculosis).
Food. Mycobacteria are transmitted through food, water. A person becomes infected through unboiled milk obtained from sick cows.
Intrauterine. The disease is not inherited, but the infection can be transmitted to the fetus from the mother through the placenta.

These are the most common ways of contracting tuberculosis.

Many are interested in the question of whether tuberculosis is transmitted through doorknobs, handrails, whether it is possible to get infected through a handshake. Such a possibility exists only if the patient who excretes mycobacteria coughed or sneezed directly into the pen. In other cases, there is no risk of infection with tubercle bacilli in this way.

The risk of infection increases with the duration of contact with a sick person. When meeting on the street or traveling in public transport, it is small. It is much more likely to get infected when a work colleague, a neighbor in the stairwell is sick. The chance of penetration of mycobacteria is especially great when living with a sick person in the same apartment, given that tuberculosis is more often transmitted by airborne droplets.

What affects the infection of children

A high degree of morbidity among the younger generation remains. The number of sick children of preschool age is increasing. Mostly these are children from risk groups, which include dysfunctional families, the homeless, migrants, refugees. The ways of transmission of tuberculosis are the same.

Factors provoking infection of the child:

No BCG vaccination.
Unbalanced diet, malnutrition.
Smoking, drinking alcohol.
Chronic disease inherited from parents.
Being close to infected people.

The factor of heredity in this case does not play a role. Among children from quite prosperous and wealthy families, the food way of contracting tuberculosis is more common, when mycobacteria enter the body with infected food.

Video

Video - how Koch's wand is transmitted

What causes infection in adults

In older people, the disease has some features. The stability of the immune defense after 55 years is sufficient to resist the development of a dangerous disseminated type of the disease.

More common is a closed form that does not manifest itself for many years. When asked whether tuberculosis is contagious in this case, the answer is no. The transition to the active form, when mycobacteria begin to multiply and spread throughout the body, is possible only under certain factors.

These include:

Poor nutrition, malnutrition.
Use of toxic products.
Abuse of tobacco and alcohol.
The use of certain drugs, especially hormonal drugs.
Experienced stress.
Metabolic disease.
Chronic pathologies.
Oncological disease.
immunodeficiency syndrome.

By eliminating these risk factors for developing TB, you can significantly reduce your chances of becoming infected.

Diagnostic methods

The disease, detected at an early stage, when it is just beginning, is easily cured.

Modern diagnostic methods help to detect the moment of appearance of tuberculosis bacilli in the body:

Mantoux test.
X-ray examination.
Fluorography.
Laboratory research.

Considering that everyone can become infected with tuberculosis, it is necessary to be regularly examined and take care of your health.

Knowing how tuberculosis develops, you need to carefully monitor your condition. Signs of a developing disease do not appear immediately. The first symptom after communicating with a sick person, when the infection has occurred, appears only after a while. The incubation period of tuberculosis in adults can last up to a year. In children, the immune system is less stable and unable to resist infection for too long. Therefore, the incubation period is shorter, and the disease often occurs suddenly. Symptoms begin to appear much earlier.

Prevention

The most basic preventive measure aimed at preventing tuberculosis is the BCG vaccination. After it, the body is reliably protected from tuberculosis bacillus for the next 15 years.

Simple methods are available to everyone to help avoid the risk of tuberculosis:

Compliance with hygiene rules. Given how contagious TB is, hands should be washed after every visit to public places.
Daily wet cleaning of the apartment using chlorine-containing detergents.
Regular ventilation of the room.
A complete, varied diet with enough vegetable fats and proteins.
Long walks in the fresh air, sports, light physical labor.

Given the way TB is transmitted, it is important to keep your immune system in good condition. Pay as much attention as possible to strengthening the defense forces. Then, even in the event of infection, the transmitted mycobacteria will not be able to become active in the body.

When the threat of infection exists, an anti-tuberculosis drug is prescribed as a prophylaxis.

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Tuberculosis has long been considered in medicine as one of the most common and dangerous diseases. Despite all the achievements of modern science, the disease cannot be defeated, people continue to die from it every year. The disease is insidious in its unpredictability, it has several behaviors.

Depending on various circumstances, tuberculosis infection can go unnoticed or cause serious health problems, even death.

Is tuberculosis contagious, and how much - we will analyze this in more detail.

The degree of danger depends on the form and stage in which the disease is determined in a person. The most dangerous is. A disease in a closed form (latent) has less ability to transmit infection to the external environment.

Having invaded the body, mycobacterium may not manifest itself for years. A person is completely unaware that his condition carries a threat to others - health does not give any signals of an “invasion”. In the meantime, the infection begins to slowly but methodically spread through the internal organs - tuberculosis intoxication of the body occurs.

Harmful bacteria travel through the cells with the blood stream, choosing to stop the most unprotected organs of the human body. Having fixed in a convenient place, mycobacteria begin their destructive work.

From this moment on, a person is considered a carrier of tuberculosis, he becomes especially dangerous for society.

If the body is strong, the immune system is mobilized to fight the aggressor. Weak immunity is not able to cope with Koch's wand on its own, it requires a long and serious treatment.

Tuberculosis begins its development with the formation of a primary affect in the affected area. Macrophages (special cells capable of aggressive capture of other bacteria, particles of dead cells, other microparticles harmful to the body) Koch sticks are captured, while penetrating into the lymphatic system.

Mycobacteria have two routes of penetration into organs: lymphogenous or hematogenous.

In the lesions, a granulomatous process begins to develop: in the central part, focal necrosis is formed, surrounded by lymphocytes, macrophages, and epithelioid cells. The result of a granuloma is sclerosis.

In medicine, it is customary to divide the disease into pulmonary and extrapulmonary forms. The first is the most common, the second is numerous and with many options.

Tuberculosis at the beginning of the journey: how contagious is the initial form of the disease

There is an opinion that in the embryonic state the infection is quite harmless and infection with tuberculosis cannot occur - the bacilli are still too weak and act on the body for a short time. However, this is not entirely true. It all depends on the form of manifestation of the disease, which regulates the degree of its contagiousness.

There is no single answer to the question of whether tuberculosis is transmitted at the initial stage. First of all, it is necessary to clarify which phase is considered the initial one: the actual introduction of mycobacteria into the organs, or its infiltrative form.

If the definition means the first option, the starting moment of tuberculosis is not terrible. In addition, the disease may not manifest itself in any way throughout the life of an infected person.

Another thing is the infiltrative phase. This stage is highly contagious, since the hallmark of this phase is a characteristic cough that sprays droplets of sputum into the environment.

The initial stage, even in the most harmless form, is a serious reason to pay attention to one's own health, so as not to miss the possible moment when non-dangerous, “dormant” tuberculosis flows into an active form with the most serious consequences.

"Risk groups": who is threatened by Koch's wand

A few years ago, it was believed that only disadvantaged sections of the population fall ill with tuberculosis - convicts in places of deprivation of liberty, persons without a fixed place of residence and other citizens leading an asocial lifestyle.

The disease in such cases had an open, chronic form and was as contagious as possible for the environment of the carrier.

Often, the disease was detected in people who are in difficult living conditions, have low incomes, and are socially unprotected. Recently, however, mycobacterium began to be diagnosed in quite well-to-do people. It turned out that no one is protected from tuberculosis - the disease is so tenacious and omnivorous.

Particularly attentive to the possibility of "acquisition" of the disease should be diabetics, people with gastrointestinal diseases, as well as in the case of permanent hormonal treatment.

The most "contagious" forms of the disease

If the diagnosis is accurately established, the first thing that interests the sick person and his everyday environment is whether the detected disease is contagious or not, how successfully it is cured.

Open pulmonary tuberculosis belongs to the category of the most dangerous diseases. This variety poses a threat to the health of not only the carrier itself, but also everyone who in one way or another comes into contact with him in everyday life.

In this case, the highest ability of mycobacteria to infect everyone within a radius of several tens of meters from the owner of the Koch wand is observed.

Transmission of a pulmonary infection occurs by airborne droplets, when the patient coughs or sneezes.

It "distributes" many of the smallest tuberculosis bacilli into the environment and soil from infected sputum, which the carrier of the disease spits out.

Tuberculosis is insidious and infectiously dangerous, "making a nest" in other organs: kidneys, bone tissues, lymphatic system, genitals. The number of those infected with extrapulmonary species is somewhat less than the owners of pulmonary tuberculosis, however, here too, severe complications and death are common results.

Infection can be avoided: measures to prevent tuberculosis

Unfortunately, even the most experienced and titled doctor is not able to guarantee protection against tuberculosis infection - the infection spread area is too large. However, a few useful knowledge helps to take measures to protect against this serious illness.

Firstly, try to avoid direct contact with carriers of an open form of tuberculosis. If contact is unavoidable (in case of illness of family members), it is not always possible to completely eliminate the risk of infection. In this case, you must carefully follow the recommendations of the doctor treating the sick relative.

The room must be ventilated and disinfected - the ability to infect tuberculosis mycobacterium retains for a long time. The patient must be allocated for individual use dishes, personal hygiene items.

The second rule is in public places, it is necessary to stay away from coughing or sneezing fellow citizens, especially if saliva is freely sprayed into the air.

The listed measures can reduce the possibility of catching an infection, however, timely vaccinations against tuberculosis, regular visits to the fluorography room and timely treatment of detected tuberculosis serve as a more significant guarantee.

There are few Ukrainians who do not know how sad the situation with tuberculosis is in our country. Rejection of the principles of work of the TB service of the times of the USSR that proved to be highly effective, scarce funding of the industry, insufficient vaccination of the population, unfavorable environmental conditions, a decrease in the level of well-being of citizens, alcoholism and drug addiction - all these factors play into the hands of tuberculosis infection, contributing to a decrease in immune protection, an avalanche spread of the disease , the formation of resistant strains of bacteria that are not amenable to therapy with standard combinations of anti-tuberculosis drugs. In the absence of real help from the state, a person is left face to face with a formidable infection, and the chances for a healthy life depend only on himself, his sanitary literacy and willpower. The most important issue that worries the layman is the risk of contracting tuberculosis in various everyday situations. How not to get sick? - let's figure it out.

In order to have a substantive conversation about the possibility of infection with tuberculosis, first of all, we will analyze the meaning of the terms infection (infection) - in relation to tuberculosis, active tuberculosis, open and closed forms of tuberculosis.

Tuberculosis is a unique infection. Ingestion of a tubercle bacillus (Koch's bacteria, Mycobacterium tuberculosis) almost always leads to infection, and very rarely to the development of active disease. Infection (infection) with Koch's bacillus occurs once in a lifetime - usually in childhood or adolescence, at the first contact of a person with a microorganism. One or two Koch sticks that have entered the child's respiratory tract along with inhaled air lead to infection and the development of local inflammation, however, due to the high activity of the immune system, the body quickly copes with the infection and self-healing occurs. All these processes occur completely imperceptibly, have no clinical manifestations and, as a rule, do not lead to the development of active tuberculosis. The fact that tuberculosis infection has occurred, doctors learn from the results of the next Mantoux test, which in people infected with tuberculosis bacillus have very specific characteristics. Immunologically, the process of infection with a tuberculosis bacillus can be considered as a favorable phenomenon, because, thanks to the contact with the pathogen, the human body learns to recognize tuberculosis and fight it - this is how anti-tuberculosis immunity is formed.

Despite the fact that the immune system has overcome the pathogen, a certain amount of mycobacteria remains forever in the human body (mainly in the organs of the lymphatic system) in an inactive state. The presence of "sleeping" bacteria becomes the basis for the development of active tuberculosis in cases where the activity of immunity decreases and tuberculosis bacilli get out of control. However, this does not always happen - according to statistics, active tuberculosis (that is, tuberculosis with clinical manifestations, specific changes on the x-ray and in the results of laboratory tests) develops only in 1-5% of infected people. The highest risk of developing tuberculosis is in the first 2 years after primary infection - it is during this period of time that an infected person needs to be monitored by a phthisiatrician and (according to indications) preventive measures. I must say that by the age of 20-25, TB infection occurs in 90-95% of people, and most of these people (despite being infected with TB) remain healthy. That is Tuberculosis is not the same as being infected!

People infected (infected) with tuberculosis do not have tuberculosis, do not spread the tuberculosis bacillus and therefore are not dangerous to others. Usually, a person infected with tuberculosis has a positive Mantoux test, while the results of a lung x-ray and sputum analysis are normal. Repeated contact of an infected person with tuberculosis pathogens either has no consequences, or breaks down the immune defense and leads to the development of active tuberculosis (usually this occurs with a massive bacterial attack, contact with aggressive strains of tubercle bacillus, temporary or permanent immunodeficiency).

Active tuberculosis that has developed for one reason or another can occur in two forms - open and closed. An open form of tuberculosis (bacterioexcretion) is said to be when bacteriological examination (inoculation) or microscopy in the sputum, saliva and other secretions of the patient reveals Koch's sticks. If there are no bacteria in the secretions during repeated studies, the patient suffers from a closed form of the disease. The terms open and closed form of tuberculosis are more often used for pulmonary tuberculosis. However, bacterial excretion is also characteristic of other types of tuberculosis - tuberculosis of the lymph nodes, tuberculosis of the reproductive system, tuberculosis of the intestine, etc. The presence of bacterial excretion (BC+) is a very important indicator of the infectious danger of a patient, since tuberculosis can only be contracted from a person who releases Mycobacterium tuberculosis into the environment. However, there is one caveat here: due to the insufficient power of laboratory research methods, in some patients with an open form of tuberculosis, mycobacteria in sputum (and other secretions) cannot be detected. That is, being, officially, non-contagious, they pose a serious danger to others. Therefore, no doctor guarantees 100% safety for people who have contacts with patients with a closed form of tuberculosis. It is believed that contact with such a patient with about a 30% probability can lead to the development of an active form of the disease, the risk of infection increases with constant, close, prolonged contact.

So, a patient with an open form of tuberculosis is definitely dangerous, a patient with a closed form is potentially dangerous.

Contact options

The risk of developing tuberculosis directly depends on the nature of the contact and determines the preventive measures necessary in each specific case.

Theoretically, the lowest probability of developing the disease is with short-term contact with a TB patient in public transport, public places, on stairwells, etc. The simplest preventive measures help to reduce the risk of developing active tuberculosis in such a situation, such as a healthy lifestyle, a balanced diet and regular annual examinations (Mantoux test - for children and adolescents under 15 years of age, fluorography of the lungs - for adolescents over 15 years of age and adults), as well as mandatory washing hands after the street, regular cleaning and airing the premises.

The risk of developing active tuberculosis increases significantly with prolonged and regular contact with a tuberculosis patient (cohabitation, regular communication at work or in free time), as well as with contacts accompanied by the exchange of biological fluids (kissing, sexual relations). Healthy people who find themselves in such a situation fall into the category of “tuberculosis contacts” and should be examined by a phthisiatrician as soon as possible. The purpose of a TB examination is to rule out an active form of tuberculosis in a contact person and to identify indications for chemoprophylaxis with anti-TB drugs. Examination of contact persons includes, as a rule, a tuberculin test (Mantoux test), X-ray examination of the chest organs, sputum examination for the presence of tuberculosis bacillus, general clinical blood and urine tests. Contact children and adolescents are examined 4 times, adults - 2 times a year. Chemoprophylaxis is carried out in persons with the highest risk of developing tuberculosis (primarily in people with immunodeficiency states, persons exposed to massive exposure to aggressive strains of tuberculosis) with the help of 1-2 anti-tuberculosis drugs prescribed in minimal dosages.

An important preventive measure aimed at reducing the risk of developing the disease is the termination of contact with the bacteria. For this, a patient with an open form of tuberculosis is hospitalized in a hospital; contact persons are advised to temporarily interrupt personal communication with the patient (until the mycobacterium disappears from the discharge), sometimes patients with an active form of tuberculosis (especially in the chronic course of the disease with permanent bacterial excretion) are provided with a separate living space. The TB patient himself and his relatives should not consider temporary isolation as a life tragedy - in most cases, if the doctor's recommendations are followed in good faith, after 2 months of therapy, bacterial excretion stops and the patient ceases to be dangerous to the people around him. In situations where it is not possible to interrupt contact with a patient with an open form of tuberculosis, all contact persons are subject to long-term prophylactic therapy with anti-tuberculosis drugs.

Children. Children, due to the peculiarities of the immune system, are at increased risk for the development of active tuberculosis. Therefore, when a patient with tuberculosis appears in the family (regardless of the form of the disease), the contact of the child with this relative should be stopped, and the child should be registered with a phthisiatrician. Tuberculosis contacts and/or initially infected children and adolescents, after being examined by a phthisiatrician and excluding the active form of tuberculosis, are not contagious, not dangerous to others and can visit children's institutions (kindergartens, schools) even if they receive prophylactic treatment with anti-tuberculosis drugs .

pregnant. Contact with a TB patient during pregnancy leads to the development of the disease with almost the same probability as contact in a non-pregnant state. First of all, the contact must be interrupted and ensured that it does not repeat itself. A pregnant woman who has been in contact with a patient with tuberculosis must carefully monitor her state of health and, if the first signs of pulmonary pathology appear, consult a doctor (therapist, phthisiatrician) for an examination. With prolonged contact with a patient with an open form of tuberculosis, the examination of a pregnant woman is performed according to the generally accepted scheme (with the exception of an X-ray examination, which is carried out using special techniques in the presence of strict indications). In most cases, chest x-rays and anti-tuberculosis drugs are deferred until the postpartum period. Contact with a patient with tuberculosis is by no means an indication for termination of pregnancy. If high-risk contact occurred at the stage of pregnancy planning, it is necessary to postpone conception until the risk has completely disappeared.

prisoners. There is a very high risk of developing tuberculosis in contact with patients serving sentences in places of deprivation of liberty or former prisoners, since these people in the vast majority of cases are carriers of aggressive strains of tuberculosis that are resistant to most anti-tuberculosis drugs. Relatives visiting sick prisoners (in case it is not possible to refuse visits for some reason) are advised to come to visits in clothes made of materials resistant to disinfectants, a headscarf that covers their hair, and a 4-layer gauze mask that covers the mouth and nose. After the visit, clothes must be soaked in a disinfectant solution (chlorantoin, domestos) for 2 hours. During the entire period of increased risk, the contact person should be examined twice a year in a tuberculosis dispensary. You must be prepared for the fact that the phthisiatrician will prescribe prophylactic anti-tuberculosis treatment. Contacts of children with TB patients are highly undesirable.

« Contact without contact". Despite the absence of direct contact with the source of infection, people who have settled in an apartment (house) where a TB patient used to live are at serious risk. Koch's sticks remain viable in the environment for a long time (they live in room dust for about a month, in books - 3 months, in dark and basement rooms up to 4-5 months) and are quite capable of causing disease in new residents. To avoid health problems, before moving in, it is necessary to find out whether the final disinfection was carried out in the apartment - the treatment of the premises by the forces of the sanitary and epidemic station. If disinfection has been carried out, it is necessary to make cosmetic repairs and then safely move into new housing. If disinfection has not been carried out, it is highly not recommended to live in an apartment before it is carried out.

Concluding the topic, we will list the situations associated with tuberculosis contact, in which an urgent consultation of a phthisiatrician (or therapist) is necessary, and we will also give recommendations for elementary prevention of tuberculosis.

Examination of a phthisiatrician regarding contact with a patient with tuberculosis is indicated in the following cases:

With close, prolonged contact with a bacterioexcretor.
If there are among the next of kin who have recovered from tuberculosis (indicates a possible genetic predisposition to the disease).
In the presence of diseases or conditions that cause a decrease in the activity of immunity, including when undergoing therapy with hormonal or cytostatic drugs.
In the presence of bad habits (smoking, alcohol abuse, drug addiction), chronic stress.
If children and adolescents came into contact with the patient.

Within a year after stopping contact with a patient with active tuberculosis, it is necessary to pay attention to the following symptoms, the appearance of which should be the reason for a premature x-ray of the lungs and a consultation with a phthisiatrician:

Prolonged, unexplained weight loss.
Dry cough lasting more than 3 weeks.
Subfebrile body temperature.
Enlarged peripheral lymph nodes.
Increasing weakness, drowsiness.
Chest pain, hemoptysis.

To reduce the likelihood of developing tuberculosis after a known or suspected exposure, it is recommended:

Do not smoke or drink strong alcoholic drinks, beer, low-alcohol mixtures.
Eat at least 150-200 g of foods rich in animal fats per day (meat, fish, eggs, milk, etc.).
Eat enough vitamins of all groups.
Do not use synthetic products (chips, fast food).
Be outdoors more often and lead an active lifestyle.
Avoid repeated close contact with patients with active tuberculosis.
Undergo regular preventive examinations (fluorography of the lungs).

Finally

Tuberculosis is dangerous, one cannot but agree with this, but the situation is not hopeless. Modern medicine makes it possible to fight this disease, and timely prevention helps to prevent its development. Be attentive to yourself and your loved ones, lead a healthy lifestyle, do not hesitate to seek advice and help from doctors - this will increase your chances for a healthy long life. Take care of your health!