In 2015, 1.8 million people died as a result of tuberculosis. The consumption, as the so dangerous infectious disease in the vernacular means is transmitted via bacteria. What is alarming is that many bacterial strains are resistant to antibiotics. The figures of the World Health Organization (WHO) are frightening: about every 20 seconds a person dies from tuberculosis (TB or TB). A tuberculosis patient can catch up to 15 people a year. One third of the world's population is considered infected. Between 4, 000 and 6, 000 new cases are reported annually in Germany.
Tuberculosis - a defeated disease?
For many years it was believed that tuberculosis, like pest and leprosy, was defeated thanks to modern medicines, better health care and hygiene. For the western industrialized countries this is largely true. But the immunodeficiency syndrome AIDS and the greater mobility of people through travel or immigration is a reason for the return of tuberculosis.
Dissemination of resistance
In Africa, Eastern Europe and Central Asia, the disease has become one of the biggest medical problems. Particularly dramatic for the sufferers is the fact that increasingly spread bacterial strains, which are resistant to most antibiotics and classical tuberculosis drugs. Such a strain - term multidrug-resistant tuberculosis (MDR-TB) - has been detected in more than 100 countries, including Western Europe and North America. Such strains develop when patients prematurely stop treatment, which is predominantly the case in the poorer countries of the world.
Resistance develops because not all bacteria are killed during therapy. That is why, especially in tuberculosis treatment, combinations of drugs are used to destroy as many germs as possible. In addition, the application must be done long enough. If patients take the medication irregularly or stop treatment, there is a risk of the disease flaring up again - this time with resistant germs.
Transmission by droplet infection
Tuberculosis is a chronic infectious disease that is almost always transmitted by tubercle bacteria via droplet infection. The pathogens are inhaled, enter the lungs. Here, the phagocytes (macrophages) attack the bacteria, but thanks to a special protective mechanism, most bacteria survive.
When the phagocyte disintegrates after work, the bacteria can become active again, new macrophages must be produced. This creates a first inflammatory focus, the so-called primary tuberculosis.
Tuberculosis: course and symptoms
Often the body protects itself by encapsulating the focus of inflammation - the pathogens do not spread further. The infected person feels no complaints. But often enough - sometimes after years - and favored by a weakened immune system, the pathogens of tuberculosis find their way into the body. Again inflammatory foci develop, not only in the lungs, but also in the kidneys, bones or brain.
The treachery of tuberculosis is its creeping course: coughing, nocturnal moderate fever attacks and weight loss are symptoms that may also point to other infectious diseases. For weeks of coughing with bloody sputum and severe physical weakness (hence the name consumption) the symptoms are already clearer.
Evidence of tuberculosis
The clear evidence is only possible by a clinical-chemical analysis, for example, the bronchial secretion.
In addition, there is the tuberculin test: A substance that is obtained from the capsules of tuberculosis bacteria is injected via a punch into the skin; a skin reaction (usually a palpable nodule) at the earliest after 72 hours indicates an infection, even if it is not an open tuberculosis.
Open tuberculosis is notifiable
Tuberculosis is contagious when a focus of inflammation breaks out, because now the pathogens reach the outside. This is the dreaded open tuberculosis that must be reported to the health department immediately. The patients are isolated because the risk of infection is very high.
The incubation period is between four and six weeks.
Treatment of tuberculosis
The infectious disease is curable if patients are treated promptly and consistently with appropriate medication. Tuberculosis is treated with a combination of several antibiotics that must be administered for about nine months. The patient must be examined regularly for two years.
Vaccination against tuberculosis
A survived tuberculosis does not protect against a new infection. Therefore, vaccination is only useful for certain people, such as medical nurses or infants and the elderly, which are exposed to a higher risk of infection, for example by infected relatives.
During vaccination, certain immune cells are activated, which ultimately reduces the risk of infection. However, according to WHO tests, numerous vaccinated individuals have experienced a general deterioration of the body's own defenses, including complications such as abscesses at the injection site, bone and bone marrow inflammations and meningitis.
Discovery of tuberculosis
On March 24, 1882, Dr. Robert Koch, head of the bacteriological department of the imperial health department in Berlin, in his lecture "Etiology of tuberculosis" of the discovery of the tubercle bacterium. Koch developed a vaccine against tuberculosis a few years later.
Due to his merits, the disease is also called "Koch's disease".