Tuberculosis: diagnosis, prevention, treatment. Measures to prevent tuberculosis disease Preventive measures to prevent the development of tuberculosis include

Judging by your diet, you don’t care about your immune system or your body at all. You are very susceptible to diseases of the lungs and other organs! It's time to love yourself and start improving. It is urgent to adjust your diet, to minimize fatty, starchy, sweet and alcoholic foods. Eat more vegetables and fruits, dairy products. Feed the body by taking vitamins, drink more water (precisely purified, mineral). Strengthen your body and reduce the amount of stress in your life.

You are susceptible to moderate lung diseases.

So far it’s good, but if you don’t start taking care of her more carefully, then diseases of the lungs and other organs won’t keep you waiting (if the prerequisites haven’t already existed). And frequent colds, intestinal problems and other “delights” of life accompany weak immunity. You should think about your diet, minimize fatty, flour, sweets and alcohol. Eat more vegetables and fruits, dairy products. To nourish the body by taking vitamins, do not forget that you need to drink a lot of water (precisely purified, mineral water). Strengthen your body, reduce the amount of stress in your life, think more positively and your immune system will be strong for many years to come.

Congratulations! Keep it up!

You care about your nutrition, health and immune system. Continue in the same spirit and problems with your lungs and health in general will not bother you for many years to come. Don't forget that this is mainly due to you eating right and leading a healthy lifestyle. Eat proper and healthy food (fruits, vegetables, dairy products), do not forget to drink plenty of purified water, strengthen your body, think positively. Just love yourself and your body, take care of it and it will definitely reciprocate your feelings.

Being infected does not mean you are sick

Everyone who has to come into contact with patients with this dangerous disease wonders how to avoid becoming infected with tuberculosis. But there is also a risk of contracting the infection for those who have nothing to do with tuberculosis patients and do not come into contact with them.

Tuberculosis is an infection that is transmitted by contact and airborne droplets.

This information may surprise you, but it is almost impossible to meet an adult uninfected with Mycobacterium tuberculosis. Contact with this microorganism usually occurs in early childhood.

A small amount of Koch bacilli enters the child’s respiratory tract, inflammation occurs, the immune system copes with it and self-healing occurs. There are no clinical manifestations, and if it were not for the positive Mantoux test in the future, the presence of tuberculosis bacteria in the body would not have been suspected.

Such infection can even be considered a beneficial phenomenon for the body - it forms anti-tuberculosis immunity.

This is exactly how the BCG vaccination works, which until recently was given to all babies immediately after birth. Weakened Mycobacterium tuberculosis was administered to the child, activating the immune defense.

Koch's rods are in a dormant state in the body and can only wake up under favorable circumstances:

in direct contact with the patient in an open manner;
in conditions of the body during which immunity drops sharply: in acute infectious diseases and exacerbations of chronic diseases;
from smoking and alcohol abuse;
with poor nutrition or prolonged malnutrition;
during prolonged stress.

The active form of tuberculosis manifests itself in only 2-4% of all infected people. Those people who have a positive Mantoux test, but there are no changes in x-rays and sputum tests, are not sick. They do not spread tuberculosis bacilli and are not dangerous to others. Anyone who becomes infected with tuberculosis at an early age without clinical manifestations is not considered sick.

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Potential for infection

The risk of infection with active strains of Koch bacillus occurs constantly. It is impossible to guarantee that only healthy people surround you in transport, on the street, in public places. How to protect yourself from tuberculosis?

In most situations, it is sufficient to follow the usual preventive measures:

wash your hands after coming from the street, especially if you had to visit places where there are large crowds of people;
try to adhere to a healthy lifestyle;
do fluorography on time.

The risk of contracting active tuberculosis will be minimized.

It is more difficult to avoid getting sick if you have to come into direct contact with people suffering from this terrible disease. But again, you need to take into account the form in which his illness occurs and what kind of communication. When exchanging body fluids, the likelihood of possible infection is higher.

Persons who come into direct contact must contact a phthisiatrician. Children under 15 years old need examination 4 times a year; adults need 2 examinations. They take sputum, urine and blood for analysis, perform a tuberculin test, and take an X-ray of the lungs. There is no need to be afraid of such an examination. No one will administer chemoprophylaxis to a healthy person!

For those who have been subjected to a massive attack by aggressive strains of mycobacteria, anti-tuberculosis drugs are prescribed in a minimal dosage that cannot harm the general condition of the body.

Pregnant women are considered to be most at risk of infection. The probability of illness is exactly the same as without it. Even if infection occurs, the pregnancy is not interrupted, and active treatment begins after birth.

You can catch the infection without direct contact with patients, if you use objects that belong to them or live in the premises in which they lived. Koch's bacilli can remain active in a warm, humid environment for up to 5 months, in book dust for up to 3, in an apartment, even with regular ventilation, in the winter months - up to 25-38 days.

Measures to prevent infection - disinfection by the sanitary and epidemiological station. It is impossible to get rid of pathogenic bacilli on your own by treating the apartment and making major repairs.

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Prevention of tuberculosis infection

To prevent the development of the disease, you must adhere to the following rules.

Do not refuse vaccinations, regularly conduct Mantoux tests for school-age children. Adults should monitor their health and have fluorography done once a year.
Eat rationally and properly. The menu must include protein foods. If you lead an active lifestyle, you cannot torture yourself with constant malnutrition, limit your diet, or eat only one type of food.
It is required to observe a work and rest schedule, give up bad habits or reduce abuse to a minimum.
Carry out hygiene measures.
Regularly wet clean the room and ventilate it.
When you have to be with a patient with tuberculosis, you should definitely take protective measures: wear masks and gloves.

There should be no false shame. Phthisiatricians get sick very rarely, although they are constantly in contact with patients. They take precautions.

Tuberculosis is considered a disease of the poor and unfortunate. However, it also affects wealthy people. Rules for the prevention of tuberculosis help people from this particular group not to become infected. Measures to prevent tuberculosis allow those people who, on duty, come into contact with the patient to avoid the disease.

Photo 1. The incidence of tuberculosis in India is one of the highest in the world, according to WHO estimates.

Tuberculosis is an infectious disease. The causative agent is Koch's bacillus. This mycobacterium multiplies in the tissues of the lungs, but also affects other organs.

Main properties of the pathogen:

resistant to environmental influences;
preserves at low temperatures;
the temperature of existence of the bacterium is 37 degrees Celsius;
has a long lifespan in unfavorable conditions.

The shelf life of the bacterium in a patient’s sputum (even dried) is up to 1 year. Prevention of the spread of the disease consists of complete disinfection of the patient’s secretions.

Photo 2. They fight tuberculosis among prisoners by placing patients in special hospitals in prisons.

On clothes, Koch's wand remains viable for up to 4 months, on the pages of books - up to six months.

The cause of tuberculosis is infection with a pathogen. Infection occurs to any person, but it does not always lead to illness. Certain conditions contribute to the development of the disease:

frequent colds;
decreased immunity;
chronic diseases;
insufficient or poor quality nutrition;
poor living conditions;
alcohol abuse, smoking, drug addiction;
human congenital pathologies.

The economic crisis that our country has been experiencing for many years has led to an increase in the number of cases and deaths due to tuberculosis.

Photo 3. A monotonous and poor diet leads to a decrease in immunity and an increased likelihood of developing tuberculosis.

Routes of infection

The source of infection is a person with an active form of the disease. In this case, Koch's bacillus is excreted with sputum. It retains the ability to infect other people for a long time, even under unfavorable conditions for its existence.

Photo 4. The most common way of spreading tuberculosis and other infectious diseases is airborne droplets.

Routes of infection:

Aerogenic:
- airborne - when inhaling air with mycobacteria;
- airborne - when air is inhaled when a sick person sneezes and coughs;
- airborne dust – when breathing in a dusty room with bacteria.
Food - when eating food with Koch sticks (usually dairy products from sick cows).
Contact – when in contact with household items that contain a source of infection.
Infection of the fetus in utero from sick pregnant women.

Once in the human body, the bacterium develops or stops reproducing, becoming covered with fibrous tissue. In the second case, stable immunity to tuberculosis appears. It protects a person from re-infection.

The table presents categories of the population with an increased risk of tuberculosis and the classification of contacts through which the disease spreads.

There are exceptions when the immune system is weakened due to serious illnesses or aggressive exposure to external factors (starvation, stress). In this case, a person may become ill if re-infected.

It’s not for nothing that they say that all diseases are caused by stress. Stress is the main cause of illness in the socially prosperous population. It would seem that a person goes in for sports, eats normally, has a relatively high income, and follows the rules of hygiene.

And suddenly the diagnosis was tuberculosis.

When interviewing the patient, it turns out that he was under the influence of a stressful situation - he was trying to earn money from morning until late at night, was experiencing discomfort or psychological pressure at work, or was divorced from his other half.

Tuberculosis develops both in the lung tissue and in other organs. If the pathogen is localized in the bones, kidneys or other places, tuberculosis is called extrapulmonary. A sick person is a carrier of infection. But it does not release the active Koch bacillus and does not pose a danger to others.

Photo 5. To diagnose tuberculosis of bones and joints, phthisis doctors use an x-ray method of examination.

: Everything you need to know about preventing tuberculosis

Source: https://no-tuberculosis.ru/tuberkulez-legkih/profilaktika/

Main types of prevention of pulmonary tuberculosis

To avoid the risk of infection with tuberculosis diseases, it is necessary to take appropriate preventive measures. There are 4 types of prevention of pulmonary tuberculosis: social, sanitary, specific (BCG vaccination), chemoprophylaxis.

To avoid the risk of infection with tuberculosis diseases, it is necessary to take appropriate preventive measures. Prevention of pulmonary tuberculosis consists of four types of measures:

Social;
sanitary;
specific (vaccination, revaccination);
chemoprophylaxis.

Let's consider each type separately.

Social preventive measures

Such prevention is designed to improve environmental conditions, improve the material condition of people, strengthen their bodies in terms of health, improve the quality of food and living conditions, develop a culture of active recreation and sports, and get rid of negative habits (alcoholism, drug addiction, smoking, etc.).

Sanitary preventive measures

This type of prevention is intended to eliminate the risk of infection of a healthy population, establish restrictions and ensure the safety of contacts of bacteria carriers with uninfected colleagues, relatives and friends. The most important condition is to provide various types of protection for infectious foci (homes, workplaces, etc.).

Infectious foci are places where patients produce massive and persistent sputum with bacteria, so it is extremely important to secure this space. Preventive measures begin with visits to outbreaks by local TB specialists, epidemiologists and local nurses from the tuberculosis dispensary within three days from the time Koch bacilli are detected in the patient.

After a thorough inspection of the premises, specialists draw up “rehabilitation” plans, which need to include disinfection, a course of treatment for the patient, a method of isolating children and adolescents, registering the patient with a phthisiatrician, regular examination of each family member, and supplying them with disinfectant solutions.

An important part of such plans is training patients and their loved ones in sanitation and hygiene standards. Infected patients should eat in separate containers and store them separately, use a separate towel, pre-disinfect, wash and boil linen using special substances.

They are also required to always carry a spittoon with a tight lid. These jars must be disinfected (boil in a solution with 2% sodium bicarbonate). After the household has been completely cured, it is advisable to carry out cosmetic repairs in the house (whitewash, paint the walls and floors).

Specific preventive measures

BCG vaccination is used as such a method of preventing pulmonary tuberculosis.

This product is considered completely harmless, has a unique specificity, is hypoallergenic and immunogenic, and can multiply and be stored in the lymph nodes of patients.

For preventive purposes, dry vaccines are used because they are the most stable and retain the required volume of live bacteria for a long time.

The duration of the post-vaccination recovery period depends on the nature of the immunomorphological state of the body and the period of spread of beneficial bacteria.

Microbes continuously grow in human bodies, thereby creating anti-tuberculosis immunity.

On the 15th day, microbacteria are transformed into L-forms, due to which they are not excreted from the body for a long period of time, providing an anti-tuberculosis effect.

The feasibility of using this method is confirmed by official statistics - the vaccinated population becomes infected with tuberculosis several times less often than unvaccinated people.

Since the beginning of the use of vaccination, the incidence of severe forms of tuberculosis in minors (miliary diseases, meningitis, caseous pneumonia), which today occur in isolated cases, has significantly decreased.

Features of the use of vaccination

Medicines containing BCG strains are administered intradermally, as it is the most effective. Vaccines are produced in the form of a snow-white powder contained in 1 mg ampoules.

The drugs are stored in the refrigerator under certain conditions (up to +8 °C). Before administration, the vaccine is diluted with 0.9% saline solution (2 ml).

Already diluted powder can be administered over 2-3 hours, after which the suspension must be disposed of.

Vaccination dosage is 50 mcg with 0.1 ml saline solution. The drug is injected with a disposable syringe into the skin of the left shoulder, having previously treated the area with ethyl alcohol. The cut of the needle should be positioned upward, and the vaccine should be injected as soon as the hole completely enters the dermis.

Injecting the solution under the skin is prohibited, as this causes a cold abscess. If the vaccination is correct, whitish swellings of 5-6 mm appear in the injection area, which will disappear after half an hour.

After the injection, it is forbidden to treat the skin with disinfectants and apply tourniquets.

Correct vaccination in 95% of cases implies the formation of a superficial scar measuring 4-10 mm at the injection site. After 1, 3, 12 months, doctors or nurses check the vaccination reaction. To do this, you need to record the size of the scar and its nature in the accounting documentation.

If you violate the method of administering the solution, various complications may arise. Usually people deal with subcutaneous cold abscess, ulcers, regional lymphadenitis (axillary, cervical, supraclavicular), keloid scars.

If symptoms of complications are detected, the patient must be examined and given the necessary course of treatment at a tuberculosis dispensary.

In our country, the vaccine is administered to any newborn (in the first week of life), and the date of vaccination and information about the vaccine are indicated in the medical record or history.

Chemoprophylaxis

This measure to prevent pulmonary tuberculosis involves the use of medications to avoid the risk of infection with Koch bacilli. It is especially important for people who are most at risk of infection to take these medications. Primary chemoprophylaxis is carried out for people of any age whose body has given a negative response to the introduction of tuberculin.

Secondary chemoprophylaxis measures are carried out in patients who have had positive reactions to tuberculin, but there are no clinical or radiological signs of the disease. These preventive measures are used for the following categories of citizens:

People who are constantly in contact with infected relatives, friends, work and study colleagues.
Clinically healthy population under 30 years of age newly infected with tuberculosis.
Persons who have sustained hyperergic reactions to tuberculin.
Newborns with infected mothers who have already fed their infants with breast milk.
People who have had a change in tuberculin reaction.
persons who have previously suffered tuberculosis, during acute illnesses, operations, injuries, pregnancy, etc., when activation of tuberculosis bacilli may occur.
Citizens who take corticosteroid hormones (due to diabetes, collagenosis, silicosis, sarcoidosis, gastric ulcers, gastrointestinal operations), which can aggravate tuberculosis.

In particularly difficult epidemiological situations, chemoprophylaxis may also be prescribed to other groups of people. As practice shows, when chemoprophylaxis is used, the number of tuberculosis diseases has decreased several times. To do this, healthy people are prescribed isoniazid or ftivazid (a course of 3 months), and in case of danger of infection, treatment is repeated twice a year.

For people who have had hyperergic reactions to the tuberculin test, it is recommended to use isoniazid and pyrazinamide (ethambutol).

The daily dosage is 10 mg per kilogram of body weight (but not more than 300 mg).

In case of intolerance to isoniazid, ftivazid is used, the daily dose of which is 20-30 mg per kilogram of weight (but not more than 500 mg). It is extremely important to take vitamins C and B6.

Source: http://tuberkulez-legkikh.ru/profilaktika-tuberkulyoza

Activities that are being carried out to combat and prevent tuberculosis, especially the common pulmonary form of the disease, are caused by the rapid increase in rates among those infected.

However, the groups of the older generation with drug, alcohol and nicotine addiction, chronic thyroid diseases, diabetes mellitus and HIV-positive are at greatest risk of infection. Therefore, early prevention of the disease is important; mandatory prevention of tuberculosis in adults and the elderly is important.

Modern medicine has a solid scientific basis and great opportunities for the most effective treatment of pulmonary tuberculosis. But do not forget that mycobacteria also develop and become resistant to new conditions.

Drug treatment in hospital

It is impossible to independently select potent drugs and carry out intensive antibacterial therapy.

The individual choice and prescription of treatment for pulmonary tuberculosis is made only by a qualified specialist, taking into account the form, duration and degree of damage to the respiratory system after a thorough diagnosis.

Subsequent successful drug therapy is carried out with anti-tuberculosis drugs hydrazidisonicotinic acid, GINK, the rifamycin group and other etiotropic drugs.

"Isoniazid". Prescribed to slow the development of mycobacteria, including intracellular microorganisms, suppress the formation of mycolic acids, and complex treatment of tuberculosis, regardless of its location.

Provides intravenous administration for 30-60 days. Each kilogram of body weight corresponds to 10-15 mg of the drug. The maximum course is 150 infusions.

Sometimes its analogs are used, such as “Fenazid”, “Ftivazid”, “Metazid”.

"Rifampicin". Semi-synthetic antibacterial agent for antimicrobial therapy. Inhibits enzymes for the formation of DNA and RNA of mycobacteria. A combination with Isoniazid, Pyrazinamide and Ethambutol is mandatory. Daily intravenous administration - up to 600 mg. For the solution, use water for injection, 5% dextrose.

"Pyrazinamide". Penetrates into foci of intracellular microorganisms. It is a potent anti-tuberculosis bactericidal agent. Duration of use - at least 3 months. For every kilogram of weight there are 1.5-2 grams of active substance.

"Streptomycin". Bactericidal semisynthetic antibiotic. Prevents the growth and development of pathogenic microorganisms, destroys the synthesis of defective proteins and the transfer of information to the DNA of the infectious agent.

"Ethambutol". It disrupts cellular metabolism and RNA synthesis of mycobacteria, stops the growth and development of tuberculosis bacillus. The drug is effective only as part of complex therapy.

Otherwise, Koch's bacillus develops resistance to the drug. A dose of 15 mg per day per kilogram of the patient’s body weight is sufficient.

The maximum amount of active substance should not exceed 2 g.

"Kanamycin". Semi-synthetic antibiotic with anti-tuberculosis action. Damages mycobacterial membranes by disrupting RNA and protein synthesis. Widely used for acid-fast bacteria Mycobacterium tuberculosis. It is prescribed intravenously in a single daily dosage of 0.5 grams.

Chemotherapy for tuberculosis

Obtaining the optimal amount of a synthetic group of etiotropic, anti-tuberculosis drugs and antibiotics is the basis for further gentle effects on the human body.

Chemotherapy methods for the treatment of tuberculosis include several combinations of drugs: H (Isoniazid), K (Kanamycin), R (Rifampicin), Z (Pyrazianmide), E (Ethambutol) and S (Streptomycin ").

I mode- primary infection. The patient receives for 2-3 months all available drugs of group HRZ, S or E at the doctor’s choice. The number of doses taken must be at least 60.

II a mode- relapse. Pulmonary tuberculosis began to progress when inappropriate treatment was prescribed with erroneous combinations and the amount of active substance. HRZES is used for about 2 months; only the HRZE group will be sufficient for 1 month. Quantity - 90 doses.

II b mode- preventing the emergence of drug resistance in tubercle bacilli. Regimen - HRZEK + Fluoroquinolone for 2 months.

III mode- an obvious form of primary pulmonary lesion without isolation of mycobacteria. For the treatment of tuberculosis, HRZE is used, 60 doses taken. The course of admission is 2 months.

IV mode- individual appointment. Corresponds to multiple resistance of Koch bacilli to antimicrobial and etiotropic agents.

Surgical treatment of pulmonary tuberculosis

Irreversible changes that have formed in the organs of the respiratory system, the development of resistance to chemotherapy and complications require surgical intervention.

Indications for immediate surgery are hemoptysis, the formation of fistulas and stones in the bronchi and lungs, the appearance of multiple scars, and impaired circulatory and respiratory functions.

Surgical methods for radical treatment of tuberculosis involve a series of operations.

Lung resection. In the absence of positive dynamics and the onset of remission after 4 or more months of the completed course of drug therapy.

To remove a lobe of the affected lung, a lobectomy is prescribed; for the cavernous or fibrocavernous stage of development, a bilobectomy is prescribed.

In case of extensive damage that provokes tuberculosis, prevention of its further spread is carried out, an operation is performed to remove the entire lung - pneumonectomy.

Thoracoplasty. It involves the removal of several ribs, usually 5-7, below the formed infiltrative change or cavity. It is advisable for surgeons to intervene during the presence of bronchial fistulas and severe fibrosis.

Cavern operations. They are carried out with subsequent drainage of the chest and opening of the cavity, cleansing its walls and removing fluid from its cavity.

Thoracostomy. Removal of ribs 2 and 3 for open treatment of pleural empyema.

Pleurectomy, lung decortication. Indications: pleural empyema, pyopneumothorax, chronic exudative pleurisy. Complete removal of formation with purulent contents from the lung.

Removal of intrathoracic lymph nodes. The success of surgery lies in the extraction of the affected caseous lymph nodes, which are the source of stones in the bronchi and the spread of tuberculosis infection.

The decision to treat pulmonary tuberculosis in patients surgically is made based on the diagnosis of tuberculoma, single and multiple cavities, cirrhotic lesions of one lung, lymph nodes and bronchi. The effectiveness of patient recovery during phthisiosurgery is more than 90% of operated patients.

Modern methods of treating pulmonary tuberculosis

Antibacterial chemotherapy does not always cope with the forms of focal and infiltrative manifestations of tuberculosis infection in the process of destruction and decay, obvious bleeding. In this case, newer methods of collapsotherapeutic treatment of tuberculosis are used:

artificial pneumothorax. Injection of gas with a special needle into the pleural cavity. The puncture is made in the axillary region between the 4th and 6th intercostal space. The volume of incoming air is controlled using fluoroscopy. The result of the therapy is a decrease in lung tension, a decrease in the volume of lesions;
pneumoperitoneum. The procedure is based on the introduction of air from the diaphragm.

In case of infiltrative, miliary form of the disease, exudative pleurisy, pathogenetic modern methods of treating tuberculosis patients are successfully used. This is a complex therapy aimed at relieving toxic poisoning of the body, normalizing the immune system using medications:

corticosteroids. "Hydrocortisone", "Prednisolone";
immunomodulators. Ascorbic acid, vitamin B1, B6 and P, sodium nucleinate;
anabolic steroids "Nerobol", insulin;
antioxidants. "Alpha - Tocopherol acetate", sodium thiosulfate;
antikinin and prokinin agents. “Parmidine”, “Andekalin”, “Lidaza”.

Not only medications can defeat tuberculosis, but also wellness treatment through advanced physical therapy. For cavernous and infiltrative forms, special anti-tuberculosis methods are prescribed:

ultrasound;
laser treatment of pulmonary tuberculosis;
decimeter wave course;
action of low-frequency magnetic field;
infrared scanning;
aerosol inhalations;
light radiation.

Basically, all these innovative methods of treating tuberculosis are combined with chemotherapeutic antibacterial treatment in sanatoriums and specialized anti-tuberculosis institutions. They have proven their beneficial effects on the human body.

Outpatient treatment of pulmonary tuberculosis

It is allowed for a patient to be outside a specialized medical institution or an anti-tuberculosis dispensary for treatment of pulmonary tuberculosis at home only in certain cases: violation of the hospital regime, voluntary refusal, in case of a closed pulmonary form, with bacterial discharge in the absence of small children in the place of residence.

Even outside the hospital, antibacterial treatment of pulmonary tuberculosis is possible in the early stages of the disease. It is imperative to continue previously initiated drug therapy with drugs such as Isoniazid, vitamin B6 and glutamic acid.

This type of treatment is organized by health services at dispensaries and hospitals. They supervise the patient's daily visits to the health facility for physical therapy.

Attending breathing exercises for tuberculosis is also necessary. The exercises are based on creating a specific sequence of inhalation and exhalation of an infected person, slow body movements and a calm rhythm. Such physical therapy is used to prevent cardiovascular and pulmonary disorders, restore respiratory function and help activate the immune system.

Diet for pulmonary tuberculosis

To increase the body's resistance and normalize metabolism, all patients without exception are recommended a special diet for pulmonary tuberculosis, which must be observed throughout the entire course of taking medications. The daily amount of calories consumed should not exceed 2600, in adolescence - 3600 kcal. All food consumed should be easily digestible and contain vitamins A, C and group B.

The list of permitted products includes baked goods, broths, beef, turkey and chicken, and boiled fish. It is especially important to take plenty of dairy and fermented milk products, eggs, fruits and vegetables. Preference should be given to dried apricots, raisins, honey and nuts, butter and vegetable fats. The exceptions are hot and spicy dishes, smoked meats, seasonings and sauces.

Prevention of tuberculosis

The danger of an epidemic and an increase in morbidity among a healthy population has led to the need to create measures to combat tuberculosis not only at the state, but also at the global level. The annual mortality rate from tuberculosis infection is more than 10 million people, of which 170 thousand are children under 14 years of age.

Of great importance in order to avoid the mass spread and infection of mycobacteria is social prevention and prevention of tuberculosis, measures of which are aimed at improving the well-being and living conditions of people, introducing a healthy lifestyle and taking measures to combat bad habits.

Chemoprophylaxis also plays an equally important role. It involves taking specialized anti-tuberculosis drugs “Isoniazid”, “Ftivazid”, B vitamins, and ascorbic acid by groups of people with an increased risk of infection. This category includes persons who constantly have contact with the patient, with severe tuberculin reactions and after a previous illness.

The protection of the health of others and constant epidemiological control over a person with confirmed isolation of bacteria from pulmonary tuberculosis is carried out by sanitary prevention.

All measures for disinfection, registration of an infected person, isolation of children from the source of the disease, training in sanitary and hygienic standards for living together with a patient are undertaken by the local phthisiatrician, epidemiologist and junior medical staff.

1768 10/03/2019 5 min.

Tuberculosis is an infectious disease that affects various organs and systems of humans or animals. The disease is caused by microbacteria; some time ago they were called “Koch bacilli”. However, today this name is somewhat outdated, since microbacteria have changed (mutated), and all pathogens have individual characteristics. Modern science knows 74 types of such microorganisms.

The name of the disease comes from the Latin tuberculum (tubercle). This is what a tuberculosis focus of inflammation looks like – a granuloma.

Definition of the disease, symptoms and first signs

There are pulmonary and extrapulmonary forms of the disease. more common, it occurs in 90% of cases. However, the idea of this disease only as a problem of the respiratory system is erroneous. Bacterial inflammation sometimes occurs in the bones or skin. Tuberculosis can affect the nervous or lymphatic system, genitals, intestines, kidneys and urinary tract, and sometimes the entire body. Depending on the area of localization of the infectious process, the symptoms of tuberculosis vary.

Depending on the characteristics of the disease, primary or secondary tuberculosis is distinguished.

The primary form of the disease occurs after the pathogen enters the bloodstream. The primary lesion (granuloma) can heal on its own. It happens that the presence of healed granulomas on the lungs can be detected after a significant period of time during an X-ray examination . However, if the granuloma does not heal, but grows, this leads to the formation of cavities filled with blood (cavities). At the same time, bacteria are spread throughout the body through the bloodstream, and more and more new foci of inflammation arise. This development of the disease leads to the appearance of a large number of granulomas, and then cavities. Without medical care, this form of tuberculosis is fatal.

Causes of open and closed forms of the disease

Tuberculosis is an infectious disease. The inflammatory process occurs as a consequence of the penetration of microbacteria into the body, which are most often transmitted by airborne droplets. In addition, the causative agent of the disease can be found not only in saliva, but also in other secretions: urine, feces, sputum. However, this only happens in the case of open tuberculosis. Patients with a closed form of the disease (the lesion does not communicate with the external environment) can be either of little or no danger to people from their environment.

The active development of the inflammatory process does not necessarily occur immediately after bacteria enter the body. Quite often, a person infected with tuberculosis does not experience any symptoms of the disease. But a latent infection can always become active.

Situations arise when a person who has already recovered becomes ill again due to another type of pathogen entering the body. Or a disease that was in remission worsens. Such situations (secondary tuberculosis) are very dangerous: foci of inflammation become extremely extensive, forming cavities filled with exudate. This type of tuberculosis often ends in the death of the patient, despite all the efforts of doctors.

Features of the spread of the strain - is the virus transmitted by airborne droplets?

Tuberculosis is a disease that can affect not only people, but also animals and even birds. Although it should be noted that in most cases a person becomes infected only with certain types of bacteria: Mycobacterium tuberculosis, Mycobacterium bovis or Mycobacterium africanum. The causative agents of tuberculosis are very “tenacious”; they can live both in the host’s body and in the air, in the ground or in water. Although the period during which the bacteria remain viable varies in each case. In water, pathogens can be dangerous for five months, but in road dust - only ten days. Bacteria can withstand drying and freezing and survive at fairly high temperatures. In water heated to 80 degrees, microorganisms survive for five minutes. However, the causative agents of the disease “do not like” sunlight. Damp and dark rooms are very dangerous from the point of view of tuberculosis infection.

The spread of the disease on the planet is quite uneven. In African and Asian countries, 80% of the population has a positive reaction to tuberculosis tests, in the USA - 10%. However, in developed countries, the rate of infection with this deadly disease is increasing. This is due to the fact that people's immunity may be affected after taking certain types of medications. The increase in the number of people infected with tuberculosis is also influenced by the spread of HIV infection. Experts believe that about one third of the world's population is infected with the bacteria Mycobacterium tuberculosis.

The problem is aggravated by the fact that once the infection enters the body, it may not manifest itself for many years. In addition, microbacteria exhibit resistance to environmental factors and remain viable for a long time. Often it is impossible to destroy it using conventional sanitary methods. Bacteria are capable of rapid mutation, which makes them resistant to existing treatments.

If infection occurs

Causes

Tuberculosis is transmitted from an infected person to a healthy person in four ways:

By airborne droplets;
By contact method;
By food;
In utero.

The contact route is infection through household items, sexual contact and at the time of kissing. You can become infected with tuberculosis through blood, having damaged areas on the skin: wounds or scratches.

You can get tuberculosis by eating dairy or meat products from infected animals.

The intrauterine route of infection does not necessarily imply infection of the child if the mother is ill. However, the risk of illness for the baby still exists.

However, strong human immunity is a serious barrier to the pathogen. Even if bacteria enter the body, a disease can develop if the appropriate conditions are present. The onset of the active form of the disease is provoked by:

Overload and stress;
, weakening the body;
Malnutrition or poor nutrition, causing vitamin deficiency;
There may be other factors influencing the development of the disease.

Treatment

Treatment of the disease depends on the severity and form of tuberculosis. L educational measures used to combat the disease:

Drug therapy (and others)
Rehabilitation activities in a sanatorium.

In some cases, surgery is necessary. Treatments can last for a long time (up to two years). They include two stages:

Intensive treatment.
Prolonged treatment phase.

During the first stage, methods are used aimed at stopping the inflammatory process and preventing the destruction of lung tissue. In addition, during this period, efforts are made to ensure that the patient ceases to be a source of infection for others. The next stage is required for the final healing of the inflammation, as well as strengthening the immune system.

Prevention of tuberculosis

Prevention of tuberculosis primarily involves strengthening the immune system. A healthy lifestyle, proper eating habits, sufficient physical activity and exposure to fresh air are necessary conditions that protect against the development of the disease. A dangerous factor leading to the development of the disease is unfavorable living conditions. It is necessary to avoid prolonged living in damp, insufficiently lit and stuffy rooms. Infection with tuberculosis can occur if sanitary and hygienic standards are not observed:

Improper preparation of meat or dairy products;
Failure to comply with hygiene rules in public places.

The risk of infection through contact with a sick person is very high. A necessary precaution to prevent the spread of infection is to place the sick person in a special medical facility. An important measure to prevent the disease is vaccination.

Video

This video will tell you about what Tuberculosis is.

conclusions

Modern antibiotics and proven and high-quality treatment methods allow us to firmly count on the patient’s recovery. In most cases, late detected diseases, mutated and multi-resistant forms of tuberculosis are dangerous. The disease will not lead to a tragic outcome if, at the first suspicious symptoms, you contact a specialist and undergo a simple examination. Is it possible to treat tuberculosis at home? Find out here.

Tuberculosis, routes of infection, first signs of the disease, preventive measures

What is tuberculosis?

Tuberculosis is a common infectious disease caused by Mycobacterium tuberculosis. Currently, not only in Russia, but also in other countries, regardless of the level of economic development, tuberculosis is a major problem, since, since 1990, there has been a widespread increase in the incidence of tuberculosis in people of all age groups. Compared to 1980-1989 morbidity increased by 3 times, and mortality from it increased by 5 times. Every year, about 1 billion people in the world become infected with tuberculosis; 8–10 million people get sick and up to 3 million people die from this infection. Therefore, every person should know what tuberculosis of the 20th century is, or as it is called the “Plague of the 20th century.” Today everyone should know how to protect themselves and loved ones from this insidious disease.

Why is tuberculosis called a social disease?

Tuberculosis is considered a social disease, because tuberculosis develops in the body of people who eat poorly, abuse alcohol, smoke, use drugs, and do not comply with sanitary and hygienic standards of behavior. In addition, anxiety, stress, and overwork contribute to this.

The following figures indicate the importance of social factors in the development of the disease. Persons who drink alcoholic beverages develop tuberculosis 20–30 times more often than people who do not drink.

Almost everyone released from an ITU (correctional labor institution) is sick with tuberculosis. People who do not comply with the sanitary, hygienic and epidemic regime, being near people with tuberculosis, become ill with it 6–10 times more often.

Chronic diseases (lung diseases, diabetes, peptic ulcers of the stomach and duodenum), various immunodeficiency conditions (especially AIDS) contribute to the development of tuberculosis.

Who discovered the causative agent of tuberculosis and proved that it is not a hereditary, but an infectious disease?

The causative agent of tuberculosis was discovered by Robert Koch. In Germany, where he lived, every seventh resident died from tuberculosis, and doctors were absolutely powerless against this terrible disease. Robert Koch began an intensive search for the infectious “agent” of this disease. Robert Koch, examining lung specimens under a microscope, noticed numerous thin rods that were arranged in groups (several at a time).

Robert Koch obtained a pure culture of bacteria with which he infected several hundred animals of different species, and they all fell ill with tuberculosis. At a meeting of the Society of Doctors in Berlin on March 24, 1882, Robert Koch made a report on the causative agent of tuberculosis he had received. And in 1911, Robert Koch received the Nobel Prize for such a great discovery.

What properties does the causative agent of tuberculosis have?

· high resistance to environmental factors; resistance to high concentrations of alkalis, mineral acids, alcohol, not afraid of cold - does not die even at a temperature of -70(); high resistance to anti-tuberculosis drugs, which often complicates the treatment of patients with tuberculosis and can be the cause of death ;the optimal temperature for their life is about + 37°C (human body temperature); at a temperature of + 23°C they remain viable for up to 7 years, in dried sputum - up to 1 year, on the pages of books - up to 3–6 months, on clothes and the patient's underwear - up to 4 months.

· they use oxygen for their vital functions (i.e. they are aerobes); grow slowly and reproduce slowly. Mycobacterium tuberculosis divides by simple division or budding and does not form spores.

Who is the source of tuberculosis?
And how can you become infected with tuberculosis?

The main source of human infection with mycobacteria are “people with open forms of tuberculosis, i.e. those who release Koch’s bacilli into the external environment. A sick person, along with sputum when coughing, sneezing, talking, releases millions of mycobacteria into the environment, which spread in the air within a radius 2-6 m, then settle along with dust on the floor, on objects and can remain viable for many years.

You can become infected with tuberculosis through close contact with people with tuberculosis. Contact infection occurs: through a kiss, through the patient’s handkerchief, through clothing, dishes, towels, bed linen and other things that have been exposed to sputum containing a large number of mycobacteria.

You can also become infected with tuberculosis from animals with tuberculosis, either through direct contact with them or by consuming milk, dairy products and meat obtained from them.

Therefore, the routes of infection with Mycobacterium tuberculosis are distinguished:

1. Aerogenic: (through the air) airborne droplets (when sneezing and coughing); airborne dust (in dusty rooms where the patient was).

2. Food (through food products).

3. Contact (through household objects).

What happens when Mycobacterium tuberculosis enters the body?

When Mycobacterium tuberculosis enters the body, infection occurs (infection), which is determined in children by the Mantoux test. Such people are called infected with Mycobacterium tuberculosis (i.e., carriers of tuberculosis infection), but this is observed only if the person has good body defenses. It is known that 75–80% of the adult inhabitants of our planet are permanent carriers of Mycobacterium tuberculosis and are infected. Live pathogens can remain in the body for a long time and do not always cause disease.

Who develops tuberculosis?

The disease develops in only 10–15% of people infected with Mycobacterium tuberculosis. The main reason for this is decreased immunity. Factors that reduce immunity include: colds, flu, infectious diseases (chicken pox, measles, whooping cough), chronic bronchitis, bronchial asthma, frequent bronchitis, diabetes, peptic ulcers of the stomach and duodenum, AIDS, use of hormonal drugs , poor nutrition, alcohol and drug abuse, smoking, physical overexertion.

The main symptoms (signs) of tuberculosis.

Tuberculosis usually develops gradually, but in some cases it can develop acutely. It resembles the course of bronchitis, respiratory viral infection, pneumonia.

The main signs of tuberculosis are symptoms of intoxication, which are manifested by: increased body temperature, often periodic increases, general weakness, malaise, fatigue, decreased appetite, irritability, decreased attention, sweating, especially at night, weight loss. If these symptoms bother you for 2-3 weeks, then infection with tuberculosis should be ruled out.

In addition, symptoms of damage to the organ where the tuberculosis process is localized also appear. Since the lungs are most often affected by tuberculosis, patients develop the following symptoms: cough, first dry, then wet with sputum. Shortness of breath is a concern, initially during physical activity. Chest pain. Or maybe hemoptysis.

How is tuberculosis diagnosed in children and adolescents?

All persons who have clinical symptoms suspicious for tuberculosis must have their sputum analyzed for testing for Mycobacterium tuberculosis.

To detect infection with Mycobacterium tuberculosis, an intradermal diagnostic Mantoux test with tuberculin is used. The test is carried out for all children once a year, and for children with an increased risk of developing tuberculosis (from contact with tuberculosis patients who are often ill) - 2 times a year. The reaction to the Mantoux test is assessed by a medical professional using a transparent ruler. The reaction to the Mantoux test is considered positive when an infiltrate (papule) with a diameter of 5 mm or more is formed.

In adolescents (15-18 years old), to identify the disease, in addition to the Mantoux test, a fluorographic examination of the respiratory system is performed, which makes it possible to identify the initial signs of pulmonary tuberculosis. This method of examination once a year is completely harmless, the dose of X-ray radiation is very small.

When suspected tuberculosis is detected in children and adolescents using the Mantoux test, or FLG, everyone is sent for consultation to a phthisiatrician.

It should be remembered that the less time has passed from the moment of detection of tuberculosis infection (using the Mantoux test) to the examination by a TB doctor, the higher the likelihood that the disease will be cured in a timely manner.

Thus, the tuberculosis process can be suspected and identified using the following methods: when conducting Mantoux tests, FLG examination, when examining sputum for Mycobacterium tuberculosis.

How to protect yourself from becoming infected with tuberculosis?

· Avoid anything that can weaken your body's defenses. Take care of your health.

· Observe the work and rest schedule.

· Nutrition should be balanced in the content of proteins, fats and carbohydrates, rich in vitamins and microelements.

· Exercise regularly

· Spend more time outdoors.

· Do not smoke, do not allow others around you to smoke

· Do not abuse alcohol or drugs.

· Ventilate the rooms where you are (classroom, apartment, etc.) more often.

· Systematically carry out wet cleaning of premises.

· Use individual utensils and hygiene products.

· Be sure to maintain personal hygiene (washing your hands after returning from the street, from transport, from the toilet and before eating).

What to do if your friend or relative has tuberculosis?

· Refer him to a doctor immediately.

· If his illness is confirmed, you should also be examined for tuberculosis.

· Support a loved one in difficult times, remind him to take his medication regularly.

· Help ensure that your loved ones complete the course of treatment until recovery.