What is tuberculosis/TB?
Tuberculosis is a serious, contagious, bacterial infection. It commonly attacks the lungs but can also spread to other parts of the body including the brain, spine, abdomen, bones and nervous system.
The infection spreads from person to person through the air when an infected person coughs or sneezes and droplets of their infected sputum are inhaled by someone else.
Untreated TB can cause severe lung damage, affecting the infected person’s ability to breathe, causing meningitis (if it spreads to the brain) and arthritis. If TB is not treated it can cause death.
If detected early, before permanent damage has been done, TB can usually be cured by treatment with antibiotics. Early recognition and treatment is the key to reducing the number of people infected and the harm caused by this dangerous but treatable condition.
How common is TB?
Tuberculosis or TB is often assumed to be a disease from the Victorian era. However, according to the World Health Organisation (WHO), TB is still one of the top ten causes of death worldwide and the leading infective cause. In 2019, 1.4 million people died and an estimated 10 million people became ill with tuberculosis worldwide. In the decade from 2000 to 2019, it is estimated that TB diagnosis and treatment saved 60 million lives.
Closer to home, Public Health England (PHE) has described tuberculosis as a global health emergency affecting a quarter of the world’s population. England has one of the highest rates of TB in Western Europe. All new diagnoses of TB infection are reported to the national surveillance system and then to WHO. This is known as TB notification. In 2019, the number of people in England who were diagnosed and reported with TB rose to 4,725. This was the first increase in TB notifications in England in nine years.
Most people notified with TB were based in major urban centres, with London accounting for over a third of cases. London has been called ‘the tuberculosis capital of Europe.’
PHE's figures for 2019 also show that:
- over 60% were male;
- over 54% were aged between 15 and 44;
- the highest rate of TB was in those aged 25 to 44;
- TB rates were up to 11 times higher among people from non-white ethnicity when compared to the white ethnic group.
What are the types and symptoms of TB?
The symptoms of TB will be different depending on whether it affects the lungs or another part of the body.
According to the NHS, the general symptoms of TB can include:
- lack of appetite and losing weight;
- night sweats;
- a high temperature (fever);
- extreme tiredness or fatigue.
Pulmonary TB affects the lungs
TB infection affecting the lungs is known as pulmonary tuberculosis. 56% of those who were notified in 2019 had pulmonary TB.
In addition to the general symptoms listed above, symptoms of pulmonary TB include:
- a persistent cough (lasting more than 3 weeks) which brings up (sometimes blood-stained) phlegm;
- gradually worsening breathlessness.
Extrapulmonary TB – in areas of the body outside the lungs
Although less common, TB infections can develop in areas of the body outside of the lungs, such as the lymph nodes, bones, digestive system, bladder, reproductive system, brain and nervous system. This is known as extrapulmonary (meaning outside the lungs) TB. In 2019, 28% of people notified with TB in England also had extrapulmonary TB in at least one other area of the body.
Someone suffering from extrapulmonary TB may experience:
- persistently swollen glands;
- abdominal pain;
- pain or loss of movement in a joint;
- persistent headache;
Diagnosis and treatment
Diagnosis of pulmonary TB is often made after a chest x-ray and a phlegm sample. If diagnosed early, pulmonary TB is straightforward to treat and can almost always be cured with a long course of antibiotics. The infected person will usually require antibiotic medication for 6 months. It is normally not necessary for the infected person to be isolated from their family during treatment, although they may need to take certain precautions to avoid spreading the infection.
Diagnosis of extrapulmonary TB may require various tests and scans, including CT, MRI and ultrasounds scans, endoscopy, blood tests and a biopsy. A combination of antibiotics and corticosteroids are usually needed to treat extrapulmonary TB.
Delays in diagnosis and treatment of tuberculosis (TB)
The World Health Organisation (WHO) and Public Health England (PHE) both emphasise that prompt diagnosis and treatment of TB can improve patient outcomes, reduce the time that the patient is infectious and reduce transmission of the disease.
Despite this awareness, PHE report that 31% of people still experience a delay of more than four months between the start of their symptoms and treatment.
There has been no improvement in delayed treatment times in England for the last five years. PHE say that on the information they hold, it is not currently possible to say whether patients presenting to their doctors late with symptoms or delays within the health service are the main cause of the symptom-to-treatment time delay.
Symptoms of tuberculosis can be mild and may increase in severity in the many months that it often takes for a diagnosis to be made. Individual symptoms of tuberculosis can also be mistaken for other conditions, such as a chest infection or viral infection, leading to further delay.
Delayed treatment of pulmonary TB can lead to permanent, irreparable lung damage. This causes the injured person to suffer a lifetime of coughing, breathlessness and chest infections, and restricts their ability to breathe.
Delayed treatment of TB infection of the brain can result in confusion, loss of consciousness and coma or permanent damage from TB meningitis. Ultimately, if left untreated, both pulmonary and extrapulmonary TB can be fatal.
Awareness of the symptoms and swift action to treat both pulmonary and extrapulmonary TB, are essential to avoid death or permanent disability from this treatable disease.
How can Boyes Turner help?
Boyes Turner’s clinical negligence team are experienced in recovering compensation for clients who have suffered serious disability and devastating injury arising from delayed diagnosis and treatment of tuberculosis (TB).
Where the permanent disability would have been avoided by earlier diagnosis and correct treatment, we can obtain compensation to help with the increased costs arising from their disability. This may include adaptations to accommodation, helping to pay for specialist equipment, care and household assistance to help restore independence, mobility and quality of life after the injury. Where the injured person has been unable to return to work, compensation can be claimed to replace their loss of earnings, bringing peace of mind and financial security.
If you or a member of your family have suffered severe injury as a result of delayed treatment for tuberculosis or other infectious disease, contact us on 0118 952 7219 or email firstname.lastname@example.org.