‘A single cough can generate tuberculosis’

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A single cough can generate more than 9,000 bacterium, in other words, TB bacteria.

This is according to Dr Wei-Ru Lin, an infectious doctor and Director of Infection Control Centre at Taiwan’s Kaohsiung Medical University Hospital (KMUH).

He gave a lecture about tuberculosis (TB) to a number of local health workers during an Infection Prevention and Control workshop at the Taiwan Health Center (THC) that took place from October 30 to November 1.

Dr Lin expressed that TB is a single-cell organism bacteria, more specifically a mycobacteria of 70 different types.

He said TB can be defined as Latent MTb infection (LTBI) and TB disease.

In relation, Dr Lin expressed that LTBI is TB bacilli (class of bacteria) that is a live dormant inside the lung but does not cause destruction of organs.

TB disease on the other hand is said to be an infectious TB bacilli that results in signs and symptoms of the disease and progressively invades and damages parts of the body.

Health workers were also told that active TB disease may occur in the lungs known as pulmonary TB or in other parts of the body, called extra pulmonary TB.

Some people may experience both cases.

Dr Lin mentioned that the most common and infectious from of TB is Pulmonary TB.

He added that the damage caused by this TB disease sends pus containing TB bacilli into the lungs, which a person with TB may cough up in spit or sputum.

The other TB disease, extra pulmonary TB is normally rare but occurs in up to 40 percent of TB cases among people living with HIV.

Dr Lin went on to speak on the transmission of TB.

He stressed that TB is transmitted through the air and once TB bacteria is inhaled it pushes its way into the lungs.

“Another thing you should know about TB is that it loves oxygen. So it often initially takes root in the oxygen-filled regions of the lungs. To get inside the lungs, TB typically travels through the nose and mouth.”

“Getting there turns out to be fairly simple. A single cough can generate more than 9,000 bacterium. A sneeze can produce triple that amount and propel the germs up to 10 feet away,” said Lin.

He stated that not all individuals who are exposed to the disease can be infected.

In the case of symptoms of TB disease, Dr Lin said due to general infection and immune response, there are symptoms like fever, night sweats, weight loss.

He then spoke about treatment for the disease which includes four drugs that are taken within two phases and both depend on whether or not the patient has been treated before.

Dr Lin said the drugs are Rifampicin (R), Isoniazid (H), Ethambutol (E) and Pyrazinamide (Z) and are the first defence used for drug sensitive tuberculosis.

The first phase is the intensive phase where all four drugs are taken for a 2-3 months period and the second phase is the continuation phase where only two drugs (rifampicin and isoniazid) are taken for 4-6 months.

Dr Lin noted that treatment support such as monitoring side effects, encouraging the patient to keep taking treatment and the provision of extra care needed (psycho-social) is also essential.

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