March 24 is World Tuberculosis Day. It commemorates the day Dr. Robert Koch announced the discovery of the Mycobacterium tuberculosis, the bacterium causing tuberculosis (TB).

The Centers for Disease Control reports, “Tuberculosis (TB) is one of the world’s deadliest diseases. One-third of the world’s population is infected with TB. In 2015, 10.4 million people around the world became sick with TB disease. There were 1.8 million TB-related deaths worldwide. TB is a leading killer of people who are HIV infected. A total of 9,557 TB cases (a rate of 3.0 cases per 100,000 persons) were reported in the United States in 2015. The overall number of TB cases in the United States increased over the previous year in 2015 after having declined yearly during 1993–2014. Despite a slight increase in case count, the TB incidence rate per 100,000 persons has remained relatively stable at approximately 3.0 since 2013.”

Humanity is fighting a long, hard war against tuberculosis. The good news is that tuberculosis can be prevented and treated. The bad news is people are still getting sick and dying from TB.  

World Tuberculosis Day exists as a reminder to stay vigilant and guard your health and the health of those you love against it. To get involved in World Tuberculosis Day activities in your neighborhood use this interactive map from the Centers for Disease Control and Prevention (CDC).

What is tuberculosis?

Tuberculosis is a bacterial disease. It usually attacks the lungs, but it can also attack the kidneys, spine, brain or other parts of the body. Interestingly, being infected with tuberculosis doesn’t always mean you will feel sick.  

There are two ways the disease can manifest. One of these is latent tuberculosis infection, when a person contracts tuberculosis, but the body attacks it and prevents it from spreading.  No symptoms appear because your body battles it. In this case, you cannot spread it to anyone else. A TB test will come back positive. You may become ill if you do not treat it.

The other manifestation is TB disease.  In this case the infected person’s immune system can no longer kill the bacteria as fast as they spread. Developing TB disease not only makes the infected person sick – it also makes them contagious to others.

A TB infection can also remain in the body of a person for a lifetime. However, if you have a weaker immune system,  for instance if you contract HIV, you will be at a greater risk for developing TB disease. TB infections blossom into TB diseases when the infected person’s immune system can no longer kill the bacteria as fast as they multiply. Developing TB disease not only makes the infected person sick – it also makes them contagious to others.

Tuberculosis infection where people feel sick present these symptoms:

  • a bad cough lasting three weeks or longer
  • pain in the chest
  • coughing up blood or sputum
  • weakness or fatigue
  • weight loss
  • no appetite
  • chills
  • fever
  • sweating at night

Tuberculosis is one of the world’s deadliest diseases. Until recently, it was on the decline in the United States, but it has been on the rise since 1993. It has since plateaued at around three cases per every 100,000 people – that’s a little more than 9,500 cases throughout the country.

In 2013, over 10.4 million people worldwide had TB disease, with 1.8 million tuberculosis-related deaths. One-third of the world is infected with tuberculosis in both latent and disease form. Tuberculosis is the leading killer of people who are infected with HIV.

Tuberculosis looks different depending on what part of the body the bacteria attacks. When tuberculosis manifests in the lungs, it displays as a bad cough for three weeks or longer, chest pain and coughing up blood or phlegm from deep inside the lungs is common. The classic image of tuberculosis or “consumption” seen  in movies is pale faces and bloody handkerchiefs.

However, since tuberculosis can manifest in so many different ways, it’s important to watch out for other more generalized symptoms: fatigue, weakness, lack of appetite, chills, fever, weight loss and night sweats.  

What should I do if I have tuberculosis symptoms?

If you believe you have been exposed to tuberculosis – whether you’re showing symptoms or not – you should go talk to a doctor immediately. You can get a tuberculosis skin test or a tuberculosis blood test. In the United States, it’s a good idea to check in with your state’s Tuberculosis Office.  

A skin test only signifies a TB infection – not whether you have latent TB or TB disease. A skin test requires the patient come back within 48-72 hours for a healthcare professional to make a determination.

Some people are more susceptible to tuberculosis than others. It has a greater effect on people who are HIV positive, people who have come into contact with tuberculosis bacteria in the past two years, babies and young children, people who use illegal drugs via injection, people who are sick with other diseases that weaken the immune system, older adults and people who were not treated properly for tuberculosis in the past.

How is tuberculosis spread?

If you spend time with someone who has been infected with tuberculosis bacteria, you are more likely to contract it. Tuberculosis bacteria become airborne when an infected person coughs, sneezes or even talks. It does NOT spread via drinking glasses, clothes, eating utensils, handshakes, toilets and other surfaces.

A TB infection can become a TB disease in days or years. It depends on the strength of your immune system.

If you work in an area where TB is often present, for example hospitals, prisons, etc., it is a good idea to get tested frequently.  Risk factors in these venues include close living quarters,  persons with a history of venous drug use, and persons with other underlying medical conditions, including relatively high rates of HIV.

How do we treat tuberculosis?

Your tuberculosis treatment plan depends on your circumstances. Make sure you talk to you doctor and make sure everyone’s up-to-date on your health and symptoms. If you have a TB infection, you need to take medication to make sure your TB infection does not become TB disease. There are four basic treatments for a TB infection:

  • Isoniazid for nine months: This is the preferred treatment for people with HIV infections, children aged 2-11 and pregnant women.
  • Isoniazid for six months: Depending on the patient’s needs, this is another option for treatment.
  • Isoniazid and Rifapentine for three months: This is the preferred treatment for people age 12 and older, who aren’t HIV positive, pregnant or infected with a resistant strain of tuberculosis.
  • Rifapentine for four months: Patients can also take rifapentine for four months to treat tuberculosis.

There are 10 commonly used drugs for treating TB disease, including Isoniazid and Rifapentine. It’s essential for patients to stick to their regimen to prevent drug-resistant TB. These require careful and complicated treatment. Inappropriate or inadequate treatment can have life-threatening results.

Where is tuberculosis still prevalent?

People in the United States die every year from tuberculosis, but incidents are still relatively uncommon. This fact is one of the most dangerous parts of the disease. Many doctors may not be considering tuberculosis when they see patients. Awareness and treatment have been improving gradually.

The World Health Organization (WHO) has been publishing annual reports on tuberculosis since 1997:

Twenty countries with the highest burdens of tuberculosis in 2015:

  1. Angola: 93 thousand cases
  2. Bangladesh: 362 thousand cases
  3. Brazil: 84 thousand cases
  4. China: 918 thousand cases
  5. Democratic People’s Republic of Korea: 141 thousand cases
  6. Democratic Republic of the Congo: 250 thousand cases
  7. Ethiopia: 191 thousand cases
  8. India: 2.8 million cases
  9. Indonesia: 1 million cases
  10. Kenya: 107 thousand cases
  11. Mozambique: 154 thousand cases
  12. Myanmar: 197 thousand cases
  13. Nigeria: 586 thousand cases
  14. Pakistan: 510 thousand cases
  15. Philippines: 324 thousand cases
  16. Russian Federation: 115 thousand cases
  17. South Africa: 454 thousand cases
  18. Thailand: 117 thousand cases
  19. United Republic of Tanzania: 164 thousand cases
  20. Vietnam: 128 thousand cases

Ten countries with the most severe tuberculosis outbreaks

  1. Cambodia: 380 cases per 100 thousand people
  2. Central African Republic: 391 cases per 100 thousand people
  3. Congo: 379 cases per 100 thousand people
  4. Lesotho: 788 cases per 100 thousand people
  5. Liberia: 308 cases per 100 thousand people
  6. Namibia: 489 cases per 100 thousand people
  7. Papua New Guinea: 432 cases per 100 thousand people
  8. Sierra Leone: 307 cases per 100 thousand people
  9. Zambia: 391 cases per 100 thousand people
  10. Zimbabwe: 242 cases per 100 thousand people

A more generalized look at incidents of tuberculosis is found at the Centers for Disease Control. Tuberculosis is a worldwide concern, but the countries where it is most common are mainly in the southern half of Africa and Southeast Asia.

You should exercise caution if you’re traveling to any of the countries on this list. Make sure you’re prepared to be in contact with people who might have tuberculosis, and know what the medical system looks like in your travel destination. You should visit a travel clinic weeks before departure to become informed and protect yourself.  The U.S. Embassy can help you find appropriate care in the country.. Serious injuries and illnesses may require evacuation. Travel insurance is a must have for this reason. It can cost more than $50,000 for medical evacuation.

How do I avoid getting/spreading tuberculosis?

There are tuberculosis vaccines available. They are not commonly used in the United States because of the low risk of infection. They’re more common in areas where tuberculosis is active. This is why visiting an expert at a travel clinic is so important.  They know best whether or not your destination country has risks of TB.

The biggest thing to remember is to keep your distance from people who have a tuberculosis infection. Once the disease is airborne, it can enter your body and affect your lungs and other organs. If you have been exposed to tuberculosis or you start experiencing symptoms, make sure you avoid spreading your germs to other people by wearing a face mask. And visit a doctor as soon as possible. Follow your medication regimen strictly in order to fully eradicate tuberculosis from your body.

If you visit a country where tuberculosis is prevalent, and you plan on spending time in areas where you’re more likely to come into contact with TB, such as crowded, closed spaces in hospitals and homeless shelters, get tested for tuberculosis before you leave. Once you return, you should test again for TB in eight to 10 weeks. Testing often is the best way to diagnose tuberculosis early and correctly treat it.

There are efforts being made worldwide to eradicate tuberculosis. In 2018, the United Nations General Assembly will hold its first high-level meeting to take on tuberculosis. Their goal is to cut tuberculosis-related deaths worldwide by 95 percent and new cases by 90 percent between 2015 and 2030.

Let’s review

You can be the first line of defense between tuberculosis and your body. Here’s a quick review of things you need to know as a global citizen – for your health, and the health of others.

  • Tuberculosis occurs everywhere: Tuberculosis is a worldwide disease, but it is more common in southern Africa and Southeast Asia. Know if tuberculosis is common in your travel destination by visiting a travel clinic.
  • Tuberculosis is preventable and curable: Tuberculosis can kill, but it’s no longer a death sentence. See your doctor before you depart and eight weeks after you return to catch any early signs of tuberculosis and treat it.
  • There are two types of tuberculosis: If you’re exposed to tuberculosis, you could develop a TB infection – which does not show symptoms and is not contagious – which may or may not develop into TB disease – which is symptomatic, contagious and possibly fatal. A TB infection can become a TB disease in days or years. It depends on the strength of your immune system.
  • Tuberculosis can look and feel different: Most people think of tuberculosis as just a lung disease, but it can impact many parts of your body. Pay attention and see a doctor if you experience symptoms of fatigue, weight loss or night sweats.
  • World Tuberculosis Day is March 24: Countries around the world are working together to put a stop to tuberculosis. You can do your part by being aware and monitoring your body and sharing the importance of being #TBSMART on social media channels like Facebook and Twitter.

Protect the people you love from TB by sharing this article and using hastag @TBsmart.  Follow us for more travel safety tips – Depart