March 25, 2011
TB, a thing of the Past? Not really!


by Patsy Wyllie
Chief Health Educator, Ministry of Health, Wellness and the Environment

The fact that there was a place called “TB Home” is a memory fast fading for many Vincentians, while others never even knew there was such a place. But, yes, where the School of Nursing now stands was once the dreaded TB Home.

Those were the days when there was a high incidence of the disease known in medical circles as Tuberculosis, but which the common man simply called “TB”.{{more}}

Back then, if you coughed too much or too long, people would look at you suspiciously and ask if you have TB. People had to be isolated due to the highly infectious nature of the disease, and for many, that was like a prison sentence, with the attendant stigma after release. The years came when one would say that “TB” is a thing of the past. But is it really so?

The truth is, Tuberculosis or “TB” is making a comeback. From 2000-2010, there was a total of one hundred and twenty-five (125) new cases of TB in St Vincent and the Grenadines. The highest numbers (20 cases) were recorded in 2010.

TB is second only to HIV as the leading infectious killer of adults worldwide. It is also the leading infectious cause of death among people with HIV. TB is an infectious disease that primarily affects the lungs, but it can also affect almost any tissue or organ in the body, including the reproductive organs and the heart. In the past, the disease was called “consumption” because of the way in which it would consume from within anyone who became infected.

Tuberculosis is an airborne disease that is easily spread from person to person through droplets of fluid that enter the air when someone who has the disease coughs or sneezes. Some people have strong immune systems that quickly destroy the bacteria once it enters body. Others will carry the bacteria but will not be contagious. Still others will become immediately sick and will also be (contagious) able to spread the bacteria to others. TB is common in areas of poor or little ventilation, for example, overcrowded homes, schools or prisons.

It is important to know that most people who are infected with the bacteria that cause tuberculosis do not actually present symptoms of the disease. However, when symptoms are present, they include unexplained weight loss, tiredness, fatigue, shortness of breath, fever, night sweats, chills and loss of appetite. The symptoms that are specific to the lungs include coughing that lasts for three weeks or more, coughing up blood, chest pain, and pain with breathing and coughing.

You can only know if you have TB by a combination of skin, sputum or imaging tests.

Success for treatment of tuberculosis depends on the taking of medication for long periods of time, usually for six months. In this regard, the patient must be disciplined and comply with the instructions of the healthcare provider.

Yesterday, March 24, 2011, was observed as World TB Day. The theme was “On the move against tuberculosis, transforming the fight towards elimination”.

When Robert Koch discovered the bacterium that causes tuberculosis March, 24, 1882, he reminded the audience that “If the importance of the disease for mankind is measured by the number of fatalities it causes, then tuberculosis must be considered much more important than those most infectious diseases like cholera and plague.”

Do not be tempted to say that it is only people with HIV that are infected with TB. The report for the last ten years does not reflect this. For example, in 2010, of the twenty new cases, only three were co-infected with TB and HIV.

Given the current trend, what we need to do is to take every precaution possible. We know that TB is linked with bad ventilation, overcrowded homes etc., but today those conditions hardly exist in St Vincent and the Grenadines.

What seems to be fueling resurgence of the disease is poor hygiene. You could stop the spread of this disease by simply covering your mouth and nose when coughing or sneezing, not sneezing in the palm of your hands. Instead, do so in the folds of your elbow. To ensure you stay protected, wash your hands frequently.