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See Dr Morton’s recover from bronchitis and pneumonia and control asthma
Whilst it is certainly true that a glittering litany of creative, bohemian types succumbed to ‘consumption’ in the pre-antibiotic era (exemplified by Puccini’s La Bohème heroine Mimi and including at least three of the Brontë siblings), there is nothing romantic about tuberculosis (TB) and it is far from being eliminated. In fact there are more people with TB on the planet now than at any time in human history.
Panic no, awareness yes.
Despite the statement above, the amount of TB in the UK remains low, with a few notable hotspots largely (though not exclusively) in major cities. There are around 8500 new cases each year and this number has been steady for almost a decade – so it isn’t spiralling out of control, but nor is it going away any time soon.
Two things are needed – exposure to somebody coughing up tuberculosis bacteria and an immune system that is overcome by the bacteria. Most people who are exposed to someone with infectious TB never become unwell with it, even though some may unknowingly harbour ‘sleeping’ tuberculosis bacteria (known as latent infection) throughout their lives. So minimising the risk of exposure and keeping generally healthy both help.
Frankly the risk in the UK is now generally really very low, but the risk was much higher 60 years ago which is why some of our older citizens remain at risk of reactivation of the latent infection they acquired in childhood. The risk of infection is higher in people who have lived for some time in countries where the burden is particularly high, such as India, China and many sub-Saharan African countries, though most people in these regions will not have TB.
When the immune system takes a hit, for example due to HIV infection or diabetes, or is deliberately suppressed with drugs used to treat conditions such as arthritis or cancer, there is a risk that latent tuberculosis will reactivate, which is why doctors might ask to do a test to rule out latent tuberculosis before starting such treatment.
‘Sleeping’ or latent infection causes no symptoms – so you wouldn’t know without a blood test or skin test, and most of the time you don’t need to know.
Active infectious tuberculosis most commonly affects the lungs and causes a sort of grumbling pneumonia – the cardinal symptoms are a new, productive cough with fever, profuse sweating at night (necessitating change of bedclothes) and weight loss (the consumption part) – not so romantic after all. Many other things can also cause these symptoms for a short period but if they continue for three weeks or more, then your doctor should probably send you to the local TB clinic for a check-up – yes, there are still clinics in hundreds of hospitals across the country!
Testing is generally straightforward and quick at a hospital, and most people tested get the all clear. If needed, treatment (a luxury not afforded by Mimi or the Brontës) is highly effective, but it does involve taking medicine every day for six months, so again, not very glamorous. However, once treatment is completed cure is more or less guaranteed.
So no need to be Les Miserables (yep, Fantine too).
Hi Nat The protection that BCG provides can vary according to when (age) and where (in the world, not where in your body!) you were vaccinated. You are probably less likely to develop TB than if you had not been vaccinated but the protection is far less absolute than, for example, is achieved after measles vaccination. There is no role for repeat or booster vaccination. In short, we need a new, better vaccine. Don’t hold your breath I’m afraid.
I had the BCG vaccine as a teenager. Am I protected against getting TB now I am an adult? And if not, do I need a booster?