According to the WHO, approximately a quarter of people in the world live with latent tuberculosis.
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Recently, the KP.RU website wrote that in Europe there is a large number of latent tuberculosis when a person does not cough. This means you are not sent for an x-ray. As a result, it turns out that tuberculosis is developing, but no one knows about it.
“Unfortunately, it is impossible to say that everything is fine with tuberculosis in the WHO European region,” said Bakhtygul Karryeva, special representative of the regional director of the WHO Regional Office for Europe in the Russian Federation. – Although, if we compare 10-year indicators (since 2015), the number of new cases has decreased by 25%. However, in 2022, more than 229 thousand people fell ill with tuberculosis.
“In fact, the causative agent of tuberculosis can live in a person in a dormant state, asleep, and not wake up for the rest of his life,” explained Irina Vasilyeva, independent chief medical officer of the Ministry of Health of the Russian Federation. director of the National Center for Medical Research in Physiopulmonology and Infectious Diseases. – It is not for nothing that it is called a socially significant problem. Due to poor conditions, reduced immunity and previous diseases, mycobacteria (Koch’s bacillus) may begin to multiply and tuberculosis will develop. I would like to note that Russia is one of the few countries in the European region that managed to maintain the pace of decline in the incidence of tuberculosis even during the pandemic. Despite the fact that all the forces of the medical community were launched into the fight against the new infection. In fact, we have better screening and better exams compared to many countries. In recent years we have achieved a constant decrease: the incidence has tripled and mortality from tuberculosis has multiplied by six. And at the moment we have reached a historical minimum in morbidity and mortality.
WHAT WORKS IN RUSSIA
* BCG vaccination for babies while they are still in the maternity ward. Like the flu vaccine, it does not protect against infection, but it does protect against the development of severe forms of tuberculosis.
* Annual Mantoux test for children. This is NOT a vaccine; It is a skin test that shows if the child is infected. The test may give a false positive and then additional tests are done. It can also be a false negative, and if the child is at risk (for example, has type 1 diabetes), additional testing may also be done. First of all – Diaskintest.
* Diaskintest is one of the three existing diagnostic tests in the world that are used to confirm tuberculosis. Our internal development was recognized in 2022 by the WHO as one of the best tools for diagnosing tuberculosis in children and adolescents.
* Fluorography for adults. It is included in the mandatory medical examination, that is, it is carried out every year. Now, in many regions, artificial intelligence helps specialists determine a possible disease, including the first stage of tuberculosis. He is the first to evaluate the results, but the radiologist gives the conclusion.
* In our country, perhaps one of all, a patient with tuberculosis is paid for a long sick leave (and treatment can last several months), as well as treatment in a sanatorium and all therapy at the expense of compulsory medical insurance .
Therefore, it is a step-by-step diagnosis and planned treatment.
IMPORTANT ANSWERS TO POPULAR QUESTIONS
1. Tuberculosis is very, very contagious.
“Mycobacteria that cause tuberculosis (Koch bacilli) are transmitted by airborne droplets, like any infectious disease,” said Irina Vasilyeva. – That is, you can get infected if you stay for a long time in the same room with a sick person, if you use things that they coughed or sneezed on, or if someone sneezed on you.
Additionally, mycobacteria can remain in the air for a long time; They do not need saliva, like the flu virus, to move between bodies. That is, if there was a sick person in the room who was coughing, and then you went in and breathed unventilated air, you could become infected.
Tuberculosis is also transmitted through the milk of sick animals (cows and goats also suffer from it), chicken eggs, and personal hygiene items. Not to mention kissing and sharing cigarettes, including electronic ones.
In the meantime, it remains to follow standard preventive measures: wash your hands, wash your face after going out
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2. So why doesn’t everyone get sick?
Given such contagion, it is strange that “only” just over 10 million people will get sick worldwide in 2022, including 1.3 million children.
In fact, nothing strange. Our immune system is capable of successfully fighting this mycobacteria. That is, it can enter our body, but remain in an inactive state, this is called non-sterile immunity. Latent tuberculosis is not contagious, it does not develop, that is, it does not present symptoms, but the Koch bacillus is present in the body.
At the same time, any provoking factor (for many it was a severe case of Covid) that reduces immunity can fuel the development of tuberculosis. Only the initial stage of this disease can be observed in fluorography. Before this, the presence of mycobacteria in the body can only be determined by tuberculosis skin testing (Mantoux test – “button”, Diaskintest) or by a positive blood test for tuberculosis.
According to the WHO, approximately a quarter of people in the world live with latent tuberculosis; Only between 5 and 10% of those infected will develop a severe form.
3. Why vaccinate children in the maternity ward.
Many are now confident that tuberculosis has been defeated in our country. In fact, victory is still very far away. Yes, people from disadvantaged sections of the population and immigrants are at risk. But no one is safe from infection. Therefore, by denying BCG, a tuberculosis vaccine, to your baby in the maternity hospital, you are risking her life.
“Infants and young children are most at risk of developing tuberculosis,” explains Andrey Prodeus, chief children’s allergist-immunologist of the Ministry of Health of the Moscow region, scientific director of the regional center for children’s allergology and immunology of the Children’s Research Institute. from the Ministry of Health of the Moscow Region. – In addition, in children, tuberculosis immediately develops into severe forms. It was not for nothing that there was such a high infant mortality rate, including due to the “consumption”: tuberculosis. And it is very important to protect the child. BCG can do this. You can’t reject it. Tuberculosis remains one of the deadliest diseases.
“Complications and deaths from tuberculosis are associated with the imperfect structure of anatomical structures (narrow bronchi, lack of cartilage), with imperfect defense mechanisms, as well as with an immature immune system,” explains Rospotrebnadzor. “The disease is especially serious in children under 2 years of age.”
4. How can adults defend themselves?
BCG doesn’t last forever. It may help the immune system for a short time. It is not in vain that children are revaccinated at 6-7 years old. But unfortunately, there is no vaccine for adults. It is believed that the immune system of an adult is already capable of dealing with Koch’s bacillus on its own. At the very least, delete it to an inactive state.
“But vaccines against tuberculosis are being developed all over the world, including our country; now two Russian vaccines are at the stage of clinical trials,” said phthisiatrician Irina Vasilyeva. – The WHO also calls on the entire world to accelerate the development of vaccines. After all, protection is necessary not only for children, but also for adolescents and adults, who account for 90% of all new cases of infection.
In the meantime, it remains to follow standard preventive measures: wash your hands and wash your face after going out. If you know someone has tuberculosis, wear a mask around them. Try to follow the basic rules of a healthy lifestyle to strengthen your immunity: sleep well, eat tasty and varied foods, walk a lot and laugh. After all, a good mood is also protection.
BY THE WAY
What are the main symptoms?
In fact, tuberculosis is not just a cough, which manifests itself already in a severe stage of the disease. In children, tuberculosis manifests itself quite quickly with the symptoms of ARVI: weakness, drowsiness, lethargy, fever, lack of appetite and (most importantly!) a rather sudden weight loss.
In adults, this includes, in addition to cough, chest pain, weakness, increased fatigue, also weight loss, sometimes (not always) fever and night sweats.
TO THE POINT
Who is at risk?
First of all, people with HIV infection. They represent on average between 20 and 25% of new cases of tuberculosis, that is, one in four new sick people. Also under special control are patients with diabetes mellitus, chronic gastrointestinal diseases, autoimmune diseases, mental illnesses and people after organ transplantation, those taking serious medications: cytostatics, glucocorticosteroids. And also those who have suffered severe Covid. In general, all those people who may have reduced immunity for various reasons.
Social risk groups include refugees, migrants, prisoners and homeless people.
