What is Tuberculosis?
Tuberculosis is a potentially severe infection caused by the bacteria “Mycobacterium Tuberculosis.” Typically, the bacteria will infect the lungs but can also affect other areas, such as the spine, brain and liver. Most Australians with Tuberculosis have not been recently infected and do not know they are at risk [1].
According to the Royal Australian College of General Practitioners, around 5% of all Australians have been affected by Tuberculosis [1]. This preferentially affects overseas-born Australians from countries and regions impacted by this condition.
Most infected individuals will have latent Tuberculosis, meaning the condition is inactive and does not lead to symptoms. Tuberculosis is at the highest risk of activating within the first five years of migrating to Australia and increases with aging [1]. Getting an early diagnosis is critical to allow appropriate management to reduce the risk of activation.
 
Tuberculosis Symptoms
Many people have latent tuberculosis infection, which causes no symptoms. However, symptoms can appear when the tuberculosis infection activates. When the condition starts and becomes symptomatic, it is known as tuberculosis disease. According to the World Health Organization, roughly 5-10% of those affected will eventually develop symptoms [2].
Symptoms of active tuberculosis disease include:
- Fever
- Cough, especially with blood and phlegm
- Weight loss
- Chest pain
- Weakness
- Night sweats
- Swelling of the lymph nodes
 
Tuberculosis Causes
Bacterial infections from Myobacterium Tuberculosis mainly cause Tuberculosis. Usually, initial transmission is caused by breathing in infected droplets. This is particularly common in Australians born in countries impacted by Tuberculosis, including Bangladesh, Yemen and the Philippines [3]. Many people infected with Tuberculosis will experience it in a latent state without symptoms. However, the infection can activate and lead to symptoms over time (typically several years after infection). This is especially prevalent in long-term steroid use and/or immunocompromised patients.
 
Is Tuberculosis Contagious?
Tuberculosis is contagious. Bacteria spread after someone inhales particles from an infected person [4]. These particles can come out from an infected person’s throat and lungs when speaking, coughing, etc. Those with latent and inactive infections cannot spread it. Typically, Tuberculosis is not spread through contact, such as by shaking hands or sharing food.
Those at high risk for infection include:
- If you have been in close contact with someone who has recently been infected with Tuberculosis
- If you have been to a country with active tuberculosis cases
- If you have a condition that affects your immune system, including cancer, diabetes, psoriasis, etc.
 
Tests and Diagnosis
Early diagnosis of tuberculosis infections is essential for appropriate medical management and to reduce the risk of activation. If you suspect that you are at high risk or exhibiting tuberculosis symptoms, please contact one of the doctors from 24-7 Medcare for support.
Your doctor may recommend the following tests to assist with a diagnosis. Those who may consider testing include:
- If someone is at a high risk of having a latent infection (e.g. those who have migrated from countries with high tuberculosis rates)
- If you work in a healthcare setting
- Before giving a BCG vaccination to a child older than six months
- Before travelling to a region with high numbers of active tuberculosis cases
Tuberculin Skin Test
Also known as the Mantoux Test, this skin assessment can help determine whether you have a tuberculosis infection [5]. Dead tuberculosis bacteria are injected onto the top layer of the skin. Reaction to the injection in the form of a small blister may suggest the presence of tuberculosis infection. Your doctor will assess the results of the skin to help determine a diagnosis.
Interferon-Gamma Release Assay
This blood test is used to detect whether someone has been exposed to the Mycobacterium Tuberculosis (bacteria responsible for infections). Like the Tuberculin Skin Test, this is used to determine whether someone has the latent form of the infection [6].
Chest X-Rays
Those with active symptoms of Tuberculosis may be referred for chest x-rays [7]. Images of the lungs will be captured to determine whether there may be an active tuberculosis infection.
Sputum Testing
Sputum or phlegm coughed up from the lungs can be used for laboratory testing. Results from these tests can determine whether someone may have an active infection. It can take up to 8 weeks to get these results back [8].
 
Tuberculosis Treatments
Tuberculosis treatment will depend on whether someone has an active or latent infection. For latent infection, the goal of the treatment is to minimise the risk of activation. Treatment of active Tuberculosis will help manage symptoms and prevent disease progression. Always talk to your doctor about treatment options.
Tuberculosis Vaccine
Vaccination for Tuberculosis (also known as Bacillus Calmete-Buèrin vaccine) can be given to help prevent developing severe disease from potential infections. However, it cannot stop the infection from occurring in the first place. Vaccines are recommended for:
- Children under five years, especially if they are travelling to areas with Tuberculosis
- Babies whose parents or carers have Tuberculosis
- Aboriginal and Torres Strait Islander babies in particular parts of Australia
Medication
Your doctor can prescribe antibacterial medications and antibiotics to help treat latent and active infections. Always follow your doctor’s instructions when taking these medications.
 
Is Tuberculosis Curable?
With the correct treatment, Tuberculosis is preventable and curable [9]. Most cases can be effectively treated when the medications are taken correctly.
 
Complications
The main complication of latent tuberculosis infection is activation. Once activated, the disease can cause the following [10]:
- Damage to the lungs, heart and other organs
- Joint damage
- Spinal injury
- Meningitis
- Horner’s syndrome
- Acute respiratory distress syndrome
- Spreading the condition to others
- \Pus developing in the lungs
 
 
Receiving quality care from highly experienced doctors is essential for a prompt diagnosis and receiving the correct medical treatment. With 24-7 MedCare, you can experience telemedicine from the convenience of your own home. Our friendly online doctors will be available 24/7 for a consultation, anytime and anywhere in Australia.
To make a telehealth appointment booking, simply click on the button below.
 
 
 
 
References
- Denholm, J., Baker, A. M., & Timlin, M. (2020). Latent tuberculosis in the general practice context. Australian Journal of General Practice, 49(3), 107-110.
- https://www.who.int/news-room/fact-sheets/detail/tuberculosis
- https://www.health.nsw.gov.au/Infectious/tuberculosis/Pages/high-incidence-countries.aspx
- https://www.cdc.gov/tb/topic/basics/howtbspreads.htm#:~:text=TB%20disease%20in%20the%20lungs,spine%2C%20is%20usually%20not%20infectious.
- https://www.healthywa.wa.gov.au/Articles/S_T/Tuberculin-Skin-Test
- https://www.health.nsw.gov.au/Infectious/tuberculosis/Pages/interferon-gamma-release-assay-test.aspx#:~:text=The%20interferon%20gamma%20release%20assay,symptoms%20suggestive%20of%20TB%20disease.
- Coulter, C. (2012). Tuberculosis testing. Australian Family Physician, 41(7), 489-492.
- https://www.health.nsw.gov.au/Infectious/tuberculosis/Pages/sputum-collection-instructions.aspx#:~:text=%E2%80%8BSputum%20is%20a%20thick,results%20from%20a%20sputum%20test.
- https://www.who.int/news-room/questions-and-answers/item/tuberculosis
- Adigun, R., and R. Singh. “Tuberculosis.” (2017).
