VOLUME 8 • ISSUE 3 • MARCH 2014
A SLICE OF ORANGE Refreshing Your Health
TEN THINGS YOU NEED TO KNOW ABOUT TB, PART 1 • TB is a tough bug • TB is easy to catch • Many people do not know
they have TB
• TB is a deadly disease
PART 1
• You need to get tested
Ten things you need to know about TB THIS DESPISED DISEASE IS VERY COMMON IN THE PHILIPPINES. HERE ARE THE MUST-KNOWS ABOUT TUBERCULOSIS.
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When I was young, I would hear from the village grapevine that Mr. So-and-so or Ate Girl-next-door has TB, and that I should stay away from them. I remember thinking, “We have a TV, too”, and then snicker at how poor the village gossips were at pronunciation.
A SLICE OF ORANGE
VOLUME 8 • ISSUE 3 • MARCH 2014
YEARS LATER, I REALIZED THAT THE JOKE WAS ON ME, LEARNING THAT I, TOO HAD A JUVENILE KIND OF TB WHEN I WAS YOUNG, A CONDITION MANY KNOW AS “PRIMARY COMPLEX.”
Confusion about tuberculosis is common because, for one, it is a very complex disease. It doesn’t help that it is covered with stigma—that the person with TB is kadiri. But TB is a very common disease, affecting 260,000 Filipinos every year. There is no room for TB ignorance in the Philippines. That’s why, in this two-part series, we will tell you about the 10 things you should know about TB.
1
People most at risk of getting infected
scenario. First of all, as mentioned be-
are those with prolonged, frequent,
fore, many patients with TB may not feel
TB is an infection caused by the bac-
or close contact with people with TB.
anything at first. Even if symptoms show
terium Mycobacterium tuberculosis. The
These include family members, house-
up, the first symptoms are very non-
term TB is short for tubercle bacillus, the
hold help, and co-workers.
specific. An infected person may first
TB is a tough bug.
other name of the TB bacterium. This name comes from the “tubercles” or nod-
notice fever, night sweats, and weight loss. Many people can easily mistake
ules that form in the lungs of an infected
When a person with
patient. The bacterial genus Mycobacte-
active TB coughs,
follow after a few weeks. As the cough
rium is a tough group. Members of this
sneezes, speaks, sings,
worsens and the bacteria starts invading
genus, including TB, are covered with a special cell wall that protects the bacte-
or spits, they expel
this for the flu or fatigue. Cough may
the blood vessels of the lungs, that is the only time you could see some blood
rium from the defenses of the body, and
microscopic aerosol
antibiotic action. As a result, if you are
droplets (a single sneeze
infected with TB, you may not feel any-
can release up to
done.
40,000 droplets).
4
thing because your body is unable to recognize and respond to it. However, during this period, you may already be
staining the sputum. At this stage, much damage to the lungs has already been
TB is a deadly disease.
infecting other people. This can go on
The high prevalence of TB in the Phil-
for months or years.
ippines further increases the chances
the lungs, lung tissue turn into mushy,
of anyone getting the bug. Other risk
cheese-like nodules. These nodules are
factors that increase one’s chances of
non-functional, and as they overrun the
getting infected include: overcrowding,
lungs, the lung function deteriorates until
TB is an airborne infection. When a
poor ventilation, poor nutrition, smoking,
the lungs eventually fail.
person with active TB coughs, sneezes,
alcoholism, and drug use.
2
TB is easy to catch.
speaks, sings, or spits, they expel microscopic aerosol droplets (a single sneeze can release up to 40,000 droplets). Each droplet may contain enough bac-
3
As the TB bacilli multiply and attack
On rare occasions, the TB bacilli hitch Many people do not
a ride in the bloodstream, and transfer
know they have TB.
to other parts of the body. When the
Modern medicine has devised a whole
TB bacilli invade the bones and spinal
teria to transmit the disease. It only takes
armamentarium of technologies to help
column, they can cause pain and nerve
10 bacteria to start an infection. People
diagnose TB. However, these are use-
damage. The meninges (the covering of
get infected when these droplets are in-
less if the infected patient does not seek
the brain and spinal cord) can also be
haled and get deposited into the lungs.
medical help—which is the common
infected, leading to meningitis.
A SLICE OF ORANGE
VOLUME 8 • ISSUE 3 • MARCH 2014
With proper treatment, these deadly
Because of these limitations, public
complications can be prevented. How-
health programs use a more specific test
ever, before you can get treated, you
that identifies people with active, infec-
must first be diagnosed.
tious TB. This test is called the sputum
5
AFB. This test requires that the patient You need to get tested.
submit three specimens of sputum, preferably collected first thing in the morn-
The most common test used to diagnose
ing. The sputum is then stained with a
TB is the chest x-ray. In a chest x-ray,
special stain, and examined under the
one could see the scars and other tissue
microscope to visualize the TB bacilli.
The PPD is a skin test that can be used
damage caused by the TB bacilli. The
Everyone with a two-week history of
to show previous history of infection,
advantage of the chest x-ray is that it is
cough unresolved by conventional treat-
including primary complex. However,
readily available in most health facilities.
ments; or those suspected of having TB
since the prevalence of primary complex
However, it has two major downsides.
based on symptoms or history of expo-
among children in the Philippines is high,
The first is that the x-ray appearance of
sure to others with TB should take a spu-
and does not necessarily lead to active
TB can be easily mistaken for other lung
tum AFB. This test is available in most
TB, this test is more relevant among chil-
conditions (and vice versa—the x-ray ap-
hospitals, laboratories, and even baran-
dren.
pearance of other lung conditions could
gay health centers.
be mistaken as TB). The second down
If you get diagnosed with TB, now
side is that x-ray findings may persist for
Nowadays, some tests can now detect
what? Is it a life sentence? Should you
many years even if the patient is fully
TB DNA. However, these tests are ex-
now hide behind shadows of shame?
treated, and what the x-ray is seeing are
pensive, and are usually reserved for
Far from it. In the next issue, you will
only scars from a fully treated disease.
those who are difficult to diagnose.
know how to battle this tough bug.
Looking to enhance your corporate healthcare benefits? E-mail us at benefits@activelinkbenefits.com. The information in this newsletter is not intended as a substitute for professional medical care. Consult a doctor for all matters relating to your health, particularly for symptoms that may require diagnosis or medical attention. © 2014 ActiveLink
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A Slice of Orange
is a newsletter designed to help clarify basic health information and offer juicy tips on uplifting your health.
Editorial team Alvin Delfin Christine Llenes-Delfin Ivan Olegario, MD