March is TB Awareness Month and ER24 is urging people to familiarise themselves with the symptoms of the disease. Seek medical attention immediately if it is suspected that you have developed TB.
TB is an infectious disease that spreads through the air. It is caused by a bacterium called mycobacterium tuberculosis. It is spread when someone who has active tuberculosis coughs, sneezes or spits. The bacterium is then inhaled by another person.
Symptoms of TB include cough, fever, night sweats, weight and appetite loss, tiredness, weakness, chest pain and coughing up blood.
People who are at high risk
Speaking about healthcare workers, Dr Vernon Wessels, from ER24 said, “Unfortunately they are by the nature of their work, at a higher risk of sustaining many infections, including TB, than the normal population. This is due to them attending to patients with undiagnosed and untreated infections.
“Any person, including trauma cases, could potentially have untreated TB. If you were inadvertently exposed, it is important to take note of any symptoms that may appear, go for testing and have treatment started as soon as possible.”
Healthcare workers should ensure they wear the relevant mask when treating patients.
Masks are crucial
“Healthcare workers are trained to use universal precautions such as gloves and an N95 mask on any patient suspected of having a respiratory infection,” said Dr Wessels.
He added it is standard practice for healthcare workers to wear an N95 or FFP2 mask when treating TB patients, especially if the patient’s response to treatment is unknown. “If the patient does not require oxygen therapy, it is practical for the patient to wear an N95 mask when in close contact with people while still infectious as this contains the TB germ and prevents spread to other people.
It should be noted that some N95 masks are fitted with an expiration valve to make it more comfortable for wearers as a person does not have to exhale through the filter material. This type of mask would however not work if a TB patient wears it as their expired air with the TB germs would exit through the valve and into the atmosphere,” said Dr Wessels.
If untreated TB is suspected, the patient should be approached with an N95 mask and preferably taken to an area where they will not be in close contact with other people.
Caroline Walker, the Advocacy, Communication and Social Mobilisation Co-ordinator at TB/HIV Care Association, said, “If your immune system is strong enough, you can inhale the TB germ but remain healthy.
Many people have latent TB. They have the TB germ but their immune system protects them from its spread. Latent TB is not infectious. There is a 10 percent risk of developing active TB if you have latent TB. If your immune system is not strong enough, you can develop active TB,” said Walker.
TB usually affects the lungs however it can affect other parts of the body.
People who are HIV positive, diabetic, malnourished or smokers have a higher chance of developing TB.
Speaking about HIV, Walker said, “The HIV virus weakens the immune system. This means it is more difficult for the body to fight off the TB germs and active TB disease develops. The most common cause of death for HIV positive adults in Africa is TB. The high co-infection of TB and HIV in Africa is the reason TB/HIV Care Association works on integrating TB and HIV services.”
“We take services to people instead of waiting for them to access care at clinics. We make it easier for people to stay in care by providing support for them to take treatment at their homes or workplaces. This is done through community care workers who form a link between the clinic and the patient, visiting the patient at home, explaining their medication and reminding them of their clinic appointments. Our mobile teams provide screening for TB and HIV counselling and testing in community settings,” said Walker.
She urged people diagnosed with TB to take their medication as prescribed by their doctor or nurse until their treatment is completed.
“For the first two weeks of treatment they should avoid close contact with others. After the first two weeks of taking treatment, a person should no longer be infectious. TB patients must continue taking their tablets until the treatment is completed,” said Walker.
TB is more likely to be spread in small, poorly ventilated and overcrowded conditions. “This means everyone should open windows when on a train, bus or taxi for example to allow for ventilation.
“Coughing etiquette should be observed. People should turn away from others and cough into their arm rather than their hand to avoid coughing germs into the air. If you spit, you should do so into a tissue and then throw the tissue away,” said Walker.
She added that kissing, shaking hands, sharing food and cutlery or touching bed linen or toilet seats, do not spread TB. To become infected, a person has to inhale TB germs.