Tuberculosis (TB) used to be a very frightening disease. Today, thanks to new drugs and better living conditions, TB is no longer the threat that it once was.

But, TB still exists. To understand the disease, learn how it is treated and what to do if you or someone you love develops it….

Tuberculosis is a disease caused by a germ called the tubercle bacillus. The germ enters the body through the air you breathe and causes an infection, usually in the lungs but sometimes in other parts of the body. Often people have an infection caused by the germ but do not develop the disease. However, when the germ is multiplying inside the body, and causing damage tot the lungs or other organs, we call it tuberculosis, or TB for short. TB was once one of the most dreaded diseases. This is understandable since, as recently as 1926, one in thirteen Canadians died of tuberculosis. In those days, the only known cures were bed rest, fresh air, good food, and in serious cases, surgery. But by the mid 1950s, several drugs had been developed to fight and prevent the disease. These drugs along with better food, housing, hygiene and education have helped to reduce the mortality rate of patients suffering from tuberculosis. However, it is important to understand that tuberculosis does still exist. Some Canadians, such as Aboriginal peoples, some immigrant groups and the urban poor, have a higher risk of developing the disease. Yet, it is also important to understand that TB can be treated very well with drugs, so once it is diagnosed the disease can be brought under control and cured within 6-12 months.

Most of the time people get TB from breathing in air which has been coughed out by someone who has an infectious case of TB. In many cases, the body can fight off the infection and surround the germs in little capsules called tubercles which are harmless. Even in a sick person's household some family members may escape infection. In fact, only about one person in 20 who is exposed to TB will develop the disease. An important thing to keep in mind is that sometimes people can develop TB several years after they were first exposed. This usually happens if the person becomes run down because of not eating well or due to poor living conditions.

A tuberculin skin test can tell you whether TB germs are present in your body. A doctor or nurse will inject a specially prepared liquid called tuberculin just under your skin. It is an almost painless test and is not a vaccination. Afew days later, the doctor or nurse will check the test spot and measure it, to see if there is any swelling. Only reactions over a certain size are considered positive.

A positive skin test means you have been exposed to TB germs. Your doctor will send you for an X-ray to see if the TB germs have damaged your lungs. But, the X-ray will not tell the difference between active and inactive disease. To diagnose active tuberculosis disease, TB germs have to be present in sputum or other clinical specimens. Although your doctor will usually start treatment right away if he or she thinks that you may have tuberculosis, (i.e. A positive tuberculin test and suspicious X-ray); the disease can only be diagnosed for sure by growing the germs in a laboratory.

TB infection means that you have TB germs in your body, but they are not doing any harm to you or to others. (This is inactive TB.) TB disease means that the germs are spreading quickly, damaging the lungs or other parts of the body and may be contagious. (This is active TB.)

If your doctor finds that you have the TB germs present in your body, he or she will prescribe drugs which will stop you from developing TB disease. These drugs are usually taken over a period of about 6 - 12 months, and to make sure it works, it must be taken as prescribed. The goal in treating a TB infection is to kill the germs that the body has walled-up in the hard capsules or tubercles which were described earlier. Even though these germs are not doing any damage now, they can become active years later and cause you to develop TB disease.

If your doctor finds that you have active TB disease, and that the germs are spreading and causing damage to your lungs or other organs, he or she will prescribe medication immediately. TB disease is usually treated by taking several special drugs over a period of several months. If you take your drugs as prescribed, you will most likely be cured within a year. You will be able to keep working during the course of treatment. However, it is a good idea not to drink alcohol while taking the TB drugs.

During treatment for TB, there are two very important things to remember.

1. Follow your doctor's directions and take the drugs exactly as he or she has recommended. If you keep forgetting to take your pills or if you only take one of them, the TB germs might become resistant to the drugs and start growing again. Then you would be forced to change medications and stay on the treatment for a longer period of time.
2. Keep taking the drugs even if you are feeling better. Although you may be feeling well, it does not mean that the disease is completely gone.

Isoniazid (INH) and Rifampin are the most commonly used drugs. Often a third drug is used at the beginning of your treatment. This third drug could be Pyrazinamide. Ethambutol or Streptomycin. The drugs should be taken all at the same time, either daily, or two or three times a week, depending on what your doctor tells you.

• Skin rashes or fever may occur with any of these drugs.
• Isoniazid interacts with some medicines used to control epilepsy.
  
• Vitamin B6 is almost always given at the same time as Isoniazid to reduce the possibility of side effects.
  
• Contact Lenses can possibly be stained - speak to your doctor about this
  
• Rifampin decreases the effectiveness of birth control pills, anticoagulants and antidiabetic pills.

One should discuss with the doctor the side-effects of the TB drugs and its possible interaction with other medication being taken.

About one in five cases of tuberculosis happens in an organ or body part other than the lungs.

Sometimes after being breathed into the lungs, the TB germs move to the lymph nodes through the lymph distribution system, and from there are able to enter other parts of the body.

Through the bloodstream. While TB can develop almost anywhere in the body, after the lungs, the most common parts are the bones and joints, and the lymphatic, reproductive, urinary and digestive systems. Your doctor may test other parts of your body to make sure that they don't have TB.

Tuberculosis is no longer a common disease, but it does still exist.

Only about 1 person in 20 exposed to the TB germ will actually develop the disease.

Several tests are required to determine if TB germs are present in the body or if TB is active or not. These tests may include a tuberculin skin test, a chest X-ray and sputum tests.

TB infection can be treated very effectively with drugs which will kill the TB germs in the body and make sure that the person does not develop TB disease later.

TB disease can also be treated effectively through a combination of powerful drugs. Treatment takes 6 to 12 months, but as long as the drugs are taken as prescribed, the disease can be cured.

TB can develop in parts of the body other than the lungs. However, modern drugs are very effective in curing these types of TB.

TB was once one of the most dreaded diseases known. However, thanks to a better understanding of the disease, modern drugs, better housing, sanitation, and improved nutrition people do not need to worry about tuberculosis.