TB or not TB, that is the question. As a public health nurse serving residents in greater Newburyport, I am often asked about TB.
TB, short for tuberculosis, is an infection caused by the bacteria mycobacterium tuberculosis. Years ago, TB was called consumption because those with the disease were weakened and consumed by the illness.
The TB bacteria is spread when an individual who has active TB disease of the lungs coughs bacteria into the air, which is inhaled in the lungs of an unsuspecting person. Once an individual breathes in the TB bacteria, the body's immune system will attempt to fight off the bacterial invasion and "wall off" the germs by encasing them in a protective capsule. It's akin to the immune system putting the TB bacteria in jail and a healthy body keeping them under lock and key.
Many healthy people live their lives having been exposed to the TB bacteria and are able to keep the germs locked up forever, never allowing the bacteria to make a "jail break." These people are categorized as having TB infection without disease, also called latent or dormant TB. People with latent TB do not feel sick and cannot pass the TB germs on to others.
However, throughout an individual's life, there are many factors that could allow the germs to escape and cause TB disease. Some of these factors are poor nutrition, advancing age and illnesses that weaken the immune system such as cancer and HIV. Many medications can also lower an individual's immune system.
If the TB bacteria becomes active, it can multiply and cause disease in many areas of the body, including bones, lymph system and the lungs. People with TB disease will feel sick, their symptoms dependent on where in their body the TB bacteria are located and multiplying. Only individuals with active TB disease in their lungs are capable of coughing the bacteria into the air and possibly infecting others. Those with TB in other parts of their body still require treatment for the illness, but it's very unlikely they will pass the germs on to others.
Public health nurses play a major role in the prevention, treatment and cure of TB. Each year in Massachusetts, there are between 200 and 300 cases of TB disease diagnosed. When a case of active lung TB disease is discovered, the nurse works to determine which people might have been exposed to the TB bacteria. These people are then tested to see if they actually breathed in the germ. Individuals whose tests show evidence of exposure to the germ are advised to begin medical treatment to prevent developing TB disease. The nurse also must make sure that the person with active TB disease takes prescribed medication as ordered, so that their disease can be cured.
Remember, TB is preventable, treatable and can be cured.
Stay healthy!
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Judy Anderson, RN, BSN, is a Newburyport resident and the public health nurse for the towns of Newbury, West Newbury, Salisbury and Georgetown.
