Tuberculosis is known as an infectious disease that can be found throughout the world, although it is prevalent in poorer countries. It is caused by the bacterium Mycobacterium tuberculosis and is transmitted through the air, namely through coughing, sneezing, spitting, speaking, and singing. People, who have a weak immune system, are predisposed to developing the disease after a prolonged and repeated exposure to a person with TB disease, but those, whose immune system is strong enough to fight the infection, have latent or inactive TB infection, and they cannot spread it to others. Nowadays, tuberculosis can be cured.
The incubation period, that is the time between being infected and the development of symptoms, can last from several weeks to years. The TB symptoms include 'prolonged coughing (sometimes including coughing up of blood), repeated night sweats, unexplained weight loss, loss of appetite, fever, chills and general tiredness' (ALA, 2008, p. 1). Usually this disease affects the lungs in the first place, but it can also affect other organs and systems, such as the kidneys, liver, spleen, spinal cord, and brain. The lymphatic system can also be affected by TB, and the lymph nodes, as well as blood, can help to spread TB in the organism. The swelling of the lymph nodes can lead to the compression of the airway structures. If not treated, the TB disease can be fatal.
Tuberculosis is often associated with 'poverty and poor public sanitation' and found in the developing countries 'located primarily in South and East Asia and Sub-Saharan Africa'. According to the Federal Bureau of Prisons,
'a significant proportion of TB cases in the U.S. occur among persons who are over-represented in certain jails or prisons, including racial/ethnic minority populations, persons with human immunodeficiency virus (HIV) infection, and persons born in foreign countries that have high rates of TB'.
It is also reported that women have a lower TB rate than men, and this is, probably, because the latter smoke more, increasing the risk of the TB disease. TB is an isolating disease, as the proper treatment requires physical isolation lasting from a few weeks to months. TB may have a negative emotional impact on the carriers of the disease, affecting their relationships with the family members, friends, and colleagues. However, this impact is temporary, because after recovering from TB, a person can return to normal life. The treatment process requires a total change of the daily routine, as the patient has to focus on the recovery. Besides physical and social impacts, TB influences the United States economy, accounting for $703.1 million spend on the screening, treatment, and prevention of the disease.
TB can be diagnosed in several different ways, namely by a TB skin test, blood test, chest X-ray, and sputum test. The treatment procedures may take from six to nine months, and consist of several antimicrobial drugs, such as isoniazid, rifampin, and pyrazin amid, which are provided with the detailed information. Constant supervision and support on part of the health workers and trained volunteers are an integral part of treatment. 'Without such supervision and support, treatment adherence can be difficult and the disease can spread'. In order to avoid an active TB infection, health professionals advise to keep one's immune system healthy, get tested regularly, take a preventive therapy, if one has latent TB, use microfiltration masks when communicating with people who have an active TB, encourage them to follow the treatment instructions, get vaccinated, eat well, and exercise regularly.
With the course of time, the bacteria that cause TB become resistant to the medicines used for treatment. As a result, a multidrug-resistant tuberculosis (MDR-TB) develops, which is 'a form of TB caused by bacteria that do not respond to, at least, isoniazid and rifampicin, the two most powerful, first-line (or standard) anti-TB drugs'. The drug resistance is accounted for the improper treatment and use of low quality medicines. According to the World Health Organization (2012) 'there were about 650 000 cases of MDR-TB present in the world in 2010. Annually, about 440 000 fell ill with MDR-TB and 150 000 died due to this form of tuberculosis'. The treatment of MDR-TB takes up more time, more expensive medicines, which are not always available, and very often the extensive chemotherapy. As the WHO underscores, the TB infection kills more adults and adolescents than any other infectious disease. Approximately one third of the world's population has a latent TB that never develops in the active disease.
The Hollywood industry pays little attention to portraying people affected by TB. In fact, the disease is curable and it can hardly be made into something dramatic like cancer experience. The Citadel, shot in 1938, is one of those rare movies that focus on TB. The promising doctor, Andrew Manson, gets his first-hand professional experience in a Welsh mining town. As a dedicated physician, he cannot pass by the illness that affects the miners. It turns out to be tuberculosis, but as soon as his experiments to prevent the disease are misunderstood, he moves to London and makes a successful career, treating the elite of the British society. The whole movie is about Manson's gradual disappointment in the medical system, and TB is left in the background. However, it gives certain insights about the symptoms of the disease.
I think that people should not be scared of TB, although some precautions are not redundant. We cannot escape the risk of being infected with TB, as long as we live in society and communicate with different people, who may not be aware that they are carriers of this infectious disease. We should constantly strengthen our immune system in order not to give the disease any chances to progress. In the long run, health is the only thing that really matters.
