Friday 24th March 2017 is World TB Day. The World Health Organisation’s theme for the day is ‘Unite to end TB: Leave No-One Behind’.
Tuberculosis is a bacterial infection which infects the lungs and other parts of the body. It is spread by coughing and sneezing as the airborne droplets of fluid are inhaled by others. Unlike a cold or the flu, TB isn’t easy to catch. It takes prolonged exposure to a TB sufferer to infect another person. In healthy people, the body’s immune system can usually deal with the bacteria. Once infected, TB bacteria can remain in the body without causing any symptoms or being contagious. This is known as latent TB. If the immune system is unable to deal with the bacteria, however, the disease spreads around the body. Over time, symptoms develop and the TB becomes active.
Tuberculosis, also known as consumption, reached epidemic levels in the 18th and 19th centuries. You might associate it with Victorian England and assume that today tuberculosis (TB) is only prevalent in developing countries. To a certain extent, that is true. Poor living conditions and lack of access to treatment in many parts of the world are factors which go some way toward explaining the 1.9 million deaths which are caused by TB throughout the world every year.
However, in 2013, Public Health England reported that the UK’s TB rates were unacceptably high when compared to other comparable countries. Our TB incidence is amongst the worst in Europe, with nearly 7,900 notified cases in 2013 – that’s 12.3 in every 100,000 people. Of those, 37.8% were based in London, with high numbers also present in other large, urban areas with greater levels of deprivation. At 60%, the largest numbers of notified cases were within the 15 to 44 age group, with the highest concentration amongst those aged 25 to 34.
In 2015 Public Health England listed the eradication of TB as one of its top seven key priorities. With early diagnosis and treatment, TB can be cured. Everyone in the UK, regardless of NHS eligibility, is entitled to free treatment for TB. If diagnosed early, it is treatable with antibiotics. As with most forms of infective disease, the later you are diagnosed, the more difficult the infection is to cure. The NICE Guideline, Tuberculosis, puts early diagnosis as the first in its listed principles of TB control. Early diagnosis depends on awareness, which is the key to vigilance and prompt action by health and social care practitioners as well as the general public. Early treatment is usually effective whereas delays in diagnosis can be devastating.
Common symptoms of TB are:
- Persistent cough lasting more than three weeks. The cough is usually productive, bringing up phlegm and sometimes contains blood. You should see a GP if you have a cough that lasts more than three weeks or if you cough up blood.
- Weight loss
- Night sweats
- High temperature
- Tiredness and fatigue
- Swellings in the neck
The good news is that with correct medical treatment, TB can nearly always be cured.
Once investigations have taken place to determine whether the disease is latent or active, located in the lungs or elsewhere, antibiotic treatment will usually be started. Tests can include scans and x-rays, blood and sputum tests, and a skin test called the Mantoux test. Close relatives, such as partners and children who live in close proximity to the TB sufferer will also be invited to be tested, to ensure that early treatment takes place. Antibiotic treatment must usually be taken for at least six months and if there is resistance to the antibiotics then other, stronger drugs will be used. Until treatment is underway, the TB sufferer may need to take some time off work or school, take precautions to avoid spreading the disease when coughing, but they will usually not need to stay away from their family or in hospital.
Awareness is key as, without it, critical TB symptoms can be mistaken for other conditions and the opportunity to treat this curable disease can be missed. At Boyes Turner we are currently acting for a young woman with a sizeable claim whose doctors failed to recognise her TB symptoms over the course of several years. By the time she was diagnosed her TB had become active, her lung damage was severe and she was classed as 50% disabled. She is no longer able to work and both her children have already become infected.