Tuberculosis used to be a common and fatal disease in the 60s in Singapore. Due to medical advancements, heightened sanitation standards, and the Singapore Tuberculosis Elimination Programme (STEP) launched in 1997, this is now a fairly rare disease. However, it has seen a resurgence in recent years. Last year, several children contracted tuberculosis from a nurse in NUH, while just last week, it was reported that a cluster of six individuals in a HDB block in Ang Mo Kio were reported to have gone to Tan Tock Seng Hospital to seek treatment for tuberculosis. Thanks to the astuteness of Dr Cynthia who identified the connection between the patients, as well the patients’ own timeliness in seeking treatment, the situation is well under control.
Although tuberculosis is highly treatable these days, it can result in health complications and even be fatal if the treatment is delayed or denied. It is important to get diagnosed and receive treatment before the disease spreads.
Tuberculosis is air-bourne, and spread through droplets released into the air by someone who has active tuberculosis, usually by actions such as sneezing, coughing, talking etc. Unlike the flu/cold which is spread by similar means, tuberculosis is much less contagious. You are far more likely to contract tuberculosis from someone you come into close contact with on a daily basis, such as a co-worker or family member, rather than a stranger who sneezed next to you on the train.
Anyone can get tuberculosis, but the immune system is a major factor in fighting the tuberculosis bacteria. Those with a weaker immune system would be more susceptible to the disease. This includes people with HIV/AIDs, diabetes, severe kidney disease, some cancers, those who are receiving cancer treatment, on certain types of drugs, or who are suffering from malnutrition. Very young children and the elderly also have weaker immune systems. People with HIV/AIDS, in particular, are encouraged to go for regular tuberculosis screening in case they have Latent Tuberculosis.
Tuberculosis has two forms:
Latent TB: The bacteria are an inactive state in the body. It is not contagious, and presents no symptoms. However, it can eventually turn into active TB, a process that can take a few weeks to a few years, and the probability is increased with a weakened immune system. It can be discovered through tuberculosis screening, and treatment at this stage is ideal to control the spread of the disease. Latent tuberculosis is contracted when infected by people with active tuberculosis.
For those who have been infected by someone with extensively drug-resistant TB (XDR TB), the latent TB will turn into the same kind of TB, which is difficult to treat via the normal medication for TB. The probability of fatality is higher. That’s why it is particularly important for people have been in frequent contact with TB bacteria carriers to go for screening, even if they don’t exhibit any symptoms of tuberculosis.
Among the most notable symptoms of tuberculosis include coughing up blood, prolonged coughing that lasts three weeks and beyond and pain in the chest, during breathing and/or coughing. Other typical symptoms of health problems may also present, including weight loss, fatigue, fever, night sweats and loss of appetite.
Because tuberculosis can affect various parts of the body aside from your chest, signs and symptoms may vary depending on the organs involved. Tuberculosis in the spine can give back pain, while tuberculosis in the kidneys may cause blood in the urine.
One should definitely consult the doctor as soon as possible if they exhibit symptoms of tuberculosis. Otherwise, irreversible damage could occur in the form of complications like spinal pain, joint damage, headache and changes to mental wellness (this is due to meningitis, or swelling of membranes that cover the brain), liver or kidney problems, and in rare cases, heart disorders.
Sources: Mayoclinic, Centers for Disease Control and Prevention, Health Promotion Board
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