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Recently, the news reported an outbreak of tuberculosis in Zeeland. We received questions about the disease, the risks of infection and treatment. Tuberculosis is one of the largest health crises in the world. By 2020, with 1.5 million victims worldwide, it was the second most deadly infectious disease after corona. There is no effective vaccine against tuberculosis. Nor are there proper tests to diagnose it correctly. And treatment takes a long time. All this makes tuberculosis a tricky disease. Martin Boeree of the Radboudumc Center of Expertise for Tuberculosis and Non-Tuberculous Mycobacteria answers five questions about it.
What is tuberculosis?
Tuberculosis is a bacterial infectious disease that affects 9 million people a year worldwide, mainly in countries below the poverty line. In the Netherlands, it is not common, but still occurs about 700 times a year.
What are the symptoms of tuberculosis?
A patient with pulmonary tuberculosis can be recognized by the symptoms of prolonged coughing, losing weight and night sweats. With examination of the mucus the patient coughs up, and a photograph of the lungs, the disease can be diagnosed. It is difficult to recognize if you don't encounter it often.
Several months after infection, tuberculosis can cause inflammation in the body in 10% of patients; the disease then usually affects the lungs. In a severe form, there are more symptoms. For example, tuberculosis can cause infections in other organs, lymph nodes, bones and the brain.
In 9 out of 10 cases after infection, no illness occurs at all; the bacteria can then hide. This is because the tubercle bacterium is able to evade the body's defenses by getting inside body cells. As a result, the immune system sometimes cannot kill the bacilli, but at best can only trap them in vesicles. Sometimes you can still develop tuberculosis many years later.
How is tuberculosis transmitted?
Tuberculosis is a contagious infectious disease that spreads through the air. You can become infected if someone who is contagious coughs or sneezes.
What are the available treatments for tuberculosis and how effective are they?
Tuberculosis is treatable, but with a relatively long course of treatment lasting six months. However, it is important to catch it early because the disease weakens the body. There is no good vaccine against tuberculosis.
The same six-month course of treatment has been used worldwide for 50 years. However, there is now intensive research into shorter treatments and treatment for resistant tuberculosis. The Radboudumc has the lead role in a large European multi-million dollar project, UNITE4TB, a multicenter consortium investigating shorter and alternative treatments in Africa, Asia and South America.
The Radboudumc Center of Excellence for Tuberculosis and Non-Tuberculous Mycobacteria is a center for treatment, advice and research. Complex patients are referred here from all over the country. Healthcare professionals can also call or email the clinical consultants for advice on diagnosis and treatment of tuberculosis. Finally, there is a diverse group of researchers active both nationally and internationally in the fields of immune, diagnostic, drug and treatment of the disease.
What preventive measures can be taken to prevent the spread of tuberculosis?
In general, the same measures apply to tuberculosis as for flu and corona, namely good cough hygiene: cough into a handkerchief or your elbow or use a mouth mask. If tuberculosis is discovered in someone, that patient will be isolated at home or in the hospital and the Public Health Service will conduct rapid source and contact investigations to see if infections have occurred and to prevent further spread.
Read more
- Netherlands leading role in development of new tuberculosis treatments
- A new step in the fight against tuberculosis - UNITE4TB announces start of clinical trials
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