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Multiple
Drug Resistant Tuberculosis (MDR-TB)
What is tuberculosis?
Tuberculosis
is a bacterial disease usually affecting the lungs (pulmonary TB).
Other parts of the body can also be affected, for example lymph
nodes, kidneys, bones, joints, etc. (extrapulmonary TB). Approximately
1,800 cases are reported each year in New York State.
Who gets tuberculosis?
Tuberculosis
can affect anyone of any age. People with weakened immune systems
are at increased risk.
How is tuberculosis
spread?
Tuberculosis
is spread through the air when a person with untreated pulmonary
TB coughs or sneezes. Prolonged exposure to a person with untreated
TB usually is necessary for infection to occur.
What is the
difference between latent tuberculosis infection and tuberculosis
disease?
Latent tuberculosis
infection (LTBI) means the person has the TB germ in their body
(usually lungs), but has yet to develop obvious symptoms. In latent
TB, the person has a significant reaction to the Mantoux skin test
with no symptoms of tuberculosis, and no TB organisms found in the
sputum. Tuberculosis disease indicates the person has symptoms,
a significant reaction to a Mantoux skin test and organisms found
in the sputum. In order to spread the TB germs, a person must have
TB disease. Having latent TB infection is not enough to spread the
germ. Tuberculosis may last for a lifetime as an infection, never
developing into disease.
What are the
symptoms of tuberculosis?
The symptoms
of TB include a low-grade fever, night sweats, fatigue, weight loss
and a persistent cough. Some people may not have obvious symptoms.
How soon do
symptoms appear?
Most people
infected with the germ that causes TB never develop active TB. If
active TB does develop, it can occur two to three months after infection
or years later. The risk of active disease lessens as time passes.
When and for
how long is a person able to spread tuberculosis?
A person with
TB disease may remain contagious until he/she has been on appropriate
treatment for several weeks. However, a person with latent TB infection,
but not disease, cannot spread the infection to others, since there
are no TB germs in the sputum.
What is the
treatment for tuberculosis?
People with
latent TB infection should be evaluated for a course of preventive
therapy, which usually includes taking antituberculosis medication
for several months. People with active TB disease must complete
a course of treatment for six months or more. Initial treatment
includes at lease four anti-TB drugs, and medications may be altered
based on laboratory test results. The exact medication plan must
be determined by a physician. Directly observed therapy (DOT) programs
are recommended for all TB patients to help them complete their
therapy.
What can be
the effect of not being treated for tuberculosis?
In addition
to spreading the disease to others, an untreated person may become
severely ill or die.
What can be
done to prevent the spread of tuberculosis?
The most important
way to stop the spread of tuberculosis is for TB patients to cover
the mouth and nose when coughing, and to take all the TB medicine
exactly as prescribed by the physician.
What is multiple
drug resistant tuberculosis (MDR-TB)?
This refers
to the ability of some strains of TB to grow and multiply even in
the presence of certain drugs which would normally kill them.
Who gets MDR-TB?
TB patients
with drug sensitive disease may develop drug resistant tuberculosis
if they fail to take antituberculosis medications as prescribed,
as well as TB patients who have been prescribed an ineffective treatment
plan. TB cases diseased with MDR-TB can transmit the drug resistant
infection to other individuals.
What is the
treatment for multiple drug resistant tuberculosis?
For patients
with disease due to drug resistant organisms, expert consultation
from a specialist in treating drug resistant TB should be obtained.
Patients with drug resistant disease should be treated with drugs
to which their organisms are susceptible. The effectiveness of treatment
for latent infection with MDR-TB is uncertain.
What can be
done to prevent the spread of MDR-TB?
Ensuring people
with MDR-TB take all their medication and teaching patients to cover
their mouth and nose when coughing and sneezing can reduce the risk
of spread of MDR-TB. In addition, directly observed therapy should
be used to ensure patients complete the recommended course of therapy.
Source
New York State Department
of Health
http://www.health.state.ny.us
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