Tuberculosis

Tuberculosis is an infectious disease caused by a tuberculosis bacterium called Mycobacterium Tuberculosis. The most common form of the disease is pulmonary tuberculosis. However, the bacteria can also infect and cause problems in other organs.

 

In the Netherlands the number of tuberculosis patients is slowly decreasing. Every year there are about 800 patients diagnosed with the disease. Tuberculosis is a great problem in many countries. Nin million people are diagnosed. More than one million people die due to tuberculosis, often because lack of sufficient treatment. The disease is difficult to combat because of this. Other factors such as HIV and antibiotic resistance cause additional treatment problems.

Pulmonary tuberculosis causes chronic coughing (more than 3weeks and sometimes blood can be coughed up) fever, fatigue, weight loss and night sweats.

Tuberculosis is treatable with a combination of antibiotics. The treatment is usually 6 months and can result in side effects. If the tuberculosis bacteria are resistant to two main antibiotics the bacteria are called multi drug resistant. The treatment duration is longer and is uninitiated in specialized tuberculosis clinics (sanatoria).

Besides medical treatment by the doctor, the patient is also guided by a nurse from the tuberculosis department of the GGD.

This guidance is mainly aimed at the following points:

  • The diagnosis tuberculosis can cause social unrest. The nurse can provide information and answer questions to the people surrounding the patient.
  • The contact investigation. If the patient is contagious the nurse will compose a list of persons who should tested. This can also include a search for the possible source of the infection.
  • The nurse also sees to that the patient is compliant in taking his or he medication and can monitor side effects. It is very important to take the medication every day and not skip treatment days. Noncompliance can lead to drug resistance and re occurrence of the disease. It is often difficult to stay compliant if you start feeling well. The nurse tries to help the patient complete the full treatment course.
  • The way and intensity of guidance can vary according to the needs and social circumstances of the patient and is estimated by the nurse during the first visit and onwards.

If someone has pulmonary tuberculosis, he or she can infect others. Persons in near with the patient have the highest risk of getting infected and are investigated first. The nurse from the tuberculosis department of the GGD will compose a list of names and invite the contacts for testing.

When a person with contagious tuberculosis sneezes or coughs, tuberculosis bacteria can travel through the air and infect others. Tuberculosis is not transmitted by touching or kissing the patient. You also will not be infected by touching things that were touched by the patient.

After an infection with the tuberculosis bacteria there is a chance of 10 % of developing the disease tuberculosis.  The most people develop the disease in the first two years after infection. However, it is also still possible years after the infection. The change to develop the disease is greater in persons with a weak immune system due to medication or underlying diseases.

An infection with the tuberculosis bacteria is well treatable. If a test shows a possible infection your doctor can prescribe medication(antibiotics) to prevent the disease. Usually this course contains a combination of two antibiotics and has a duration of 3 to 4 months after which the chances of getting the disease are minute.

In countries where tuberculosis is common many children receive a BCG vaccination shortly after they are born. This protects and prevents them from getting the disease and its serious complications. In the Netherlands only children younger than 12 years receive this vaccination if one or both parents are from a country where tuberculosis is common.

Adults are only eligible if they travel to high country with a high incidence of tuberculosis and/ or are exposed due to a high risk setting such as for example working in a healthcare facility abroad.

Ask your doctor/ general practitioner for a referral. With this referral you can make an appointment by sending an email to the tuberculosis department of the GGD.

Don’t you have a doctor/ general practitioner to refer you then you can call or send an email to the tuberculosis department of your GGD.