Bronchiectasis: Symptoms, causes, and risk factors

What Are The Symptoms Of Tuberculosis?

Tuberculosis (TB) symptoms vary depending on whether the disease is active or latent. Symptoms typically affect the lungs and may include a persistent, productive cough, fatigue, and fever.

TB is a bacterial disease that typically affects the lungs. TB symptoms vary depending on what type a person has and where in the body the TB bacteria are growing.

In this article, we will explore the symptoms of TB, including different kinds of TB, its causes, and treatment. We will also examine how to prevent TB transmission and who is most at risk of contracting the disease.

How TB symptoms present will depend on each individual, their overall health, and where in their body the infection occurs.

According to the United Kingdom's National Health Service (NHS), a person may not begin to experience symptoms until months or years after the initial infection.

Pulmonary tuberculosis

Usually, TB bacteria grow in the lungs. Doctors call this pulmonary TB. Symptoms of this form of TB may include:

Extrapulmonary tuberculosis

TB infections can sometimes occur outside the lungs. Health professionals call this extrapulmonary TB.

Areas where TB bacteria can grow include the:

General TB symptoms occurring across the body may include:

Latent tuberculosis infection

TB does not necessarily make everyone sick. If their immune system is functioning well, a person can have TB bacteria living in the body without developing any of the symptoms above. Doctors refer to this as a latent TB infection.

A person with a latent TB infection:

will not feel sick

will not display any symptoms

cannot spread TB to others

However, they may develop TB symptoms if they do not receive treatment in some cases. Additionally, people with latent TB have a higher risk of developing symptoms if they come into contact with someone with an active TB infection.

A bacterium called Mycobacterium tuberculosis causes TB.

TB bacteria, which spread through airborne droplets, transmit when someone with an active TB infection in the lungs coughs, speaks, or sneezes and another person inhales the droplets.

According to the NHS, while TB transmits in a similar way to a common cold or flu virus, it is less contagious. Typically, a person would need to spend a lot of time in close contact with someone with an active TB infection for the TB bacteria to transmit to them. For example, they could be living together.

Because of this, the bacteria is highly unlikely to spread to someone sitting or standing near a person with TB, such as on public transport.

Additionally, the bacteria does not usually transmit from children or those with extrapulmonary TB to other individuals.

People living with HIV are most at risk from TB. According to the World Health Organization (WHO), a person living with HIV is between 14 and 18 times more likely to develop TB disease than someone without HIV.

Around the world, TB is the number one cause of death among people with HIV. In 2022, around 167,000 people died of HIV-related TB, according to the WHO. The reason for this outlook is that HIV and TB each speed up the other's progress.

The best treatment for TB will depend on what type a person has and where the bacteria is in their body.

Active tuberculosis treatment

If someone has an active TB disease, they will most likely receive treatment using a combination of antibiotic medications for 6–12 months.

The most common medication for active TB is isoniazid (INH) alongside:

ethambutol

rifampin

pyrazinamide

A person may start to feel better after just a few weeks on medication. However, TB typically takes much longer to treat than other bacterial infections.

People should continue to take their full course of antibacterial medication as their doctor instructs, even if they start to feel better before they have finished the full course.

If an individual stops taking the medication sooner than their doctor advises, their immune system may have more difficulty fighting the infection. They may then:

experience symptoms again

risk the transmission of TB to others

have difficulty fighting the disease in the future

contribute to the development of drug-resistant TB

Latent tuberculosis treatment

If a person has a TB infection but does not have active TB symptoms, they should still seek preventive therapy. This form of treatment eliminates germs that may cause problems should the disease become active.

The most common type of preventive therapy is a dose of INH. A person typically consumes this as a single tablet daily for 6–9 months. A latent TB infection cannot spread to other individuals.

Drug-resistant tuberculosis treatment

Drug-resistant TB occurs when medications that doctors initially prescribe to treat TB are no longer capable of beating the TB bacteria in a person's body.

When TB develops a resistance to multiple medications, doctors call it multidrug-resistant TB (MDR TB). This form of TB is severe and dangerous. Treatment for MDR TB takes longer than any other type of TB, typically around 20–30 months. A person may experience more side effects from this type of treatment.

The risk of developing drug-resistant TB can depend on multiple factors. For example, a person may be more likely to experience drug-resistant TB if they live in a part of the world where this form of the condition is more common. They may also experience it if they have come into contact with someone else experiencing drug-resistant TB.

To prevent the spread of TB, a person can try the following:

They can seek medical attention if symptoms such as persistent cough, fever, or unplanned weight loss occur. Early TB treatment can prevent the spread of the disease and improve the likelihood of recovery.

If someone has TB, they should take the entire course of antibiotics to prevent symptoms from returning and TB bacteria becoming drug-resistant.

If someone is at higher risk for TB, such as if they are living with HIV or living with a person with TB, they should undergo testing for the condition.

If someone has a TB infection, they should practice proper hygiene when coughing or sneezing by avoiding close contact with others, wearing a face covering, and properly disposing of used tissues.

What symptoms of TB a person develops will depend on what type of TB they have and where in the body the infection occurs.

Symptoms of pulmonary TB include chest pain and a productive cough lasting 3 weeks or more. Other TB symptoms include weakness or fatigue, chills, fever, and night sweats.

Treatment for TB involves taking antibiotics. People should always take the full course of antibacterial drugs their doctor prescribes to prevent symptoms from returning and TB bacteria from becoming drug-resistant.

Free HIV Treatment To Be Launched For Children

On the eve of the World AIDS Day (Dec 1), India will launch a new scheme to provide free treatment to 20,000 HIV infected children, Health Minister Anbumani Ramadoss said here Monday.

"On Nov 30, we will be launching a scheme to provide free ARV treatment for children using paediatric anti-retroviral (ARV) drugs. We have established a protocol for the paediatric drugs and three to four pharmaceutical companies are part of the process," Ramadoss told delegates at the ongoing India Economic Summit here, jointly organised by the World Economic Forum and the Confederation of Indian Industry (CII).

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"Initially we aim to provide free treatment to 20,000 children. We have been intensely campaigning but have so far being able to identify only 1,500 children for treatment," the minister said.

The state-run National AIDS Control Organisation (NACO) estimates there are around 65,000 kids with HIV infection, out of an estimated 5.2 million HIV infected people in the country.

The health ministry is targeting providing free ARV treatment to 100,000 people through hospitals and health clinics in the country by next year.

So far around 48,000 people are getting the treatment under government run programmes while over 15 companies are also helping to provide treatment to an estimated 35,000 employees, the minister said.

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In addition, the government is planning to set up distribution of free and subsidised condoms through vending machines installed at strategic locations like truck hubs and red light area.

"So far we have installed 13,000 condom-vending machines and plan to add 12,000 more by 2006-07 fiscal end (March 31). By 2007 end we hope to have in place 100,000 vending machines," the minister stated.

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In addition to the problem of tackling a rise in number of HIV/AIDS cases in the country, the minister said an estimated 60 percent of the people have got tuberculosis due to the reluctance to come forward for treatment leaving them vulnerable to opportune diseases.

Besides HIV, India is striving to provide free treatment to an estimated 1.8 million people who are diagnosed to have tuberculosis every year.

Annually about 1.4 million receive treatment for tuberculosis under the directly observed short-course treatment strategy (DOTS), which has been yielding considerable good results.

In the last six years, around 6.3 million people have been cured of tuberculosis, the minister stated.

Source-IANSSRM

What Is Meningitis, Is It Contagious And What Are The Symptoms?

Symptoms of meningitis include a high temperature, headache, vomiting, a stiff neck and being unable to tolerate bright light

Meningitis, particularly bacterial meningitis, can be deadly if left untreated: according to the World Health Organization, around one in six people affected by this type of meningitis die, and around one in five suffer from severe, long-term complications. Meningitis is contagious and can be transmitted by asymptomatic carriers, infecting anyone of any age. Therefore, understanding what causes it, what the symptoms are and how to protect against it is vital for the health of you and your family.

What is meningitis?

Meningitis takes its name from the membranes it affects and inflames, which are called meninges. These surround and protect the brain and spinal cord. Dr Stuart Sanders, a GP at the London General Practice, a private clinic in Harley Street, describes it as "an infection affecting the brain, which can be caused by bacteria entering the bloodstream and is most commonly due to a meningococcus". This is a bacteria commonly carried in the back of the nose and in the throat, even by those who are not unwell.

Pneumococcus, tuberculosis or haemophilus bacteria may be at the root of the illness too, according to Sanders. "Meningitis can also be caused by a number of viruses including enteric, mumps or herpes viruses, although these are usually less serious," he says.

Regardless of the cause, meningitis is a condition that demands urgent attention. Although both adults and children can be affected, meningitis tends to be more common in children, with the highest incidence among those under five.

What are the signs and symptoms of meningitis?

Because some of the symptoms of meningitis are flu-like, self-diagnosis in the early stages can be tricky. According to Prof Vijay Nayar of Healthium Clinics, "The symptoms of meningitis can develop quite quickly and include a high temperature, headache, vomiting, a stiff neck and being unable to tolerate bright light. Symptoms of more severe infection include a rash that does not disappear when a glass is rolled over it, as well as drowsiness and fits. Urgent medical attention is required if some of these symptoms are present".

If you notice a rash is present, try rolling a glass over it to see whether or not it fades - Dorling Kindersley ltd/Alamy Stock Photo

What are the different types of meningitis?

According to the charity Meningitis Now, there are different kinds of meningitis, including bacterial, viral and fungal – although, says Claire Donovan, a helpline and information nurse manager at the charity, fungal meningitis is extremely rare in the UK.

"Viral meningitis is more common and usually less serious than bacterial meningitis," she says. "Even so, the symptoms can be very similar, so urgent medical care should be sought to determine which type of meningitis it is." Our bodies are usually quite good at fighting off the viruses that can cause meningitis, and with painkillers, rest and hydration, the body's immune system will overcome the virus in around seven to 10 days. However, viral meningitis can still make someone feel very ill, and full recovery can take some time.

Several types of virus can cause meningitis, including the mumps virus, the herpes simplex virus (which usually causes genital warts and cold sores) and enteroviruses, which tend to only result in mild stomach discomfort.

The reason why bacterial meningitis can be so dangerous is because of the rapidity with which harmful bacteria can multiply, and the way that bacteria can overcome our natural defences. "Certain bacteria have the ability to invade the blood-brain barrier, which helps to protect the brain from harmful substances," says Donovan. With the meninges infected, bacterial meningitis can quickly become fatal if left untreated, and it can have severe consequences for survivors, such as limb amputation if sepsis results.

Because the symptoms of bacterial and viral meningitis are so similar, you should seek urgent medical help if you have them: only medical examination will be able to determine which type of meningitis is present.

Is meningitis contagious?

Meningitis is not highly contagious and the infecting organism can live harmlessly in people's noses or throats. According to Meningitis Now, "Around 10 per cent of the population carry meningococcal bacteria (one of the most common causes of bacterial meningitis) in the back of their throat at any one time."

This "carrier state" can last for several months before disappearing, but in this time these asymptomatic carriers can transmit the illness via "droplets", through sneezing, coughing or intimate kissing. In most cases, the carriage of these bacteria does not cause illness, and it is only rarely that the bacteria overcome the body's defences and cause meningitis.

"Meningitis can also be caught from someone else with the illness," says Dr Safia Debar, a GP executive health at Mayo Clinic Healthcare in London. "Whether the infection takes hold will depend on the susceptibility of the individual." In other words, if your immunity is high, you can be in contact with someone who has or carries meningitis but not get it.

How is meningitis treated?

According to Nayar, "People who are suspected of having meningitis should have tests in hospital to establish whether it is viral or bacterial." This is done via a lumbar puncture, where a needle is inserted into the base of the spine to withdraw fluid that will then be examined for an accurate diagnosis.

As viral meningitis is less serious it can often be dealt with at home, as it tends to get better on its own within seven to 10 days with adequate rest and fluids, plus painkillers where necessary.

"Bacterial meningitis, on the other hand, requires antibiotics and needs to be treated in hospital," he says.

Nayar adds that immediate, emergency treatment is essential for bacterial meningitis. "Although viral meningitis rarely causes any long-term problems, bacterial infections can lead to complications, especially when not treated quickly," he says.

What are the complications of meningitis?

In severe cases, meningitis can lead to death, says Dr Chun Tang, a GP and medical director at Pall Mall Medical, a private healthcare clinic in Manchester. Other potential complications include neurological damage and hearing loss.

According to the Meningitis Research Foundation, the problems following meningitis can be temporary or permanent, and can encompass both physical and mental health issues, including brain damage.

"The membranes around the brain are like a bag of fluid," explains Claire Donovan. "When these become inflamed with meningitis, the intracranial pressure can press down on the brain and cause damage."

After-effects of meningitis include memory loss and difficulty concentrating, reduced physical coordination and balance, headaches, problems with speech, sight and hearing, physical weakness and spasms, and mental health or behavioural issues. If septicaemia is brought on by meningitis, then damage to the kidneys and lungs can result, as well as joint pain and stiffness. In extreme cases, amputation may be required to remove damaged tissue and prevent the infection spreading further throughout the body.

Who is most at risk of meningitis?

Meningitis can affect anyone, especially if they have been weakened by a coexisting illness or infection, says Sanders. However, newborn babies and young children are at the greatest risk of contracting the illness. This is because their immune systems are not yet fully developed, which also means that premature babies are even more vulnerable. Other heightened risk factors for young children include those who suffer frequently with sinus infections, have cochlear ear implants, or have recently sustained a head injury.

Is there a vaccination to prevent meningitis?

Yes, says Nayar, adding that vaccinations are our best defence against the illness, providing some protection against certain types of meningitis.

"Some of these vaccinations are given to babies as part of the routine childhood immunisation programme and a further vaccine is offered to teenagers and young adults," she says. "These are safe and effective, and the combination of infant and adolescent vaccinations provides good protection against this potentially life-threatening infection."

However, adds Donovan, not all types of meningitis are covered by vaccines, and no vaccine offers 100 per cent protection. This is why it is still vital to seek medical help if symptoms are detected, even if someone has been vaccinated.

Not all types of meningitis are covered by vaccines - South_agency/E+

Which types of vaccines are available?

Meningococcal vaccines protect against meningococcal bacteria, which can cause meningitis and septicemia. There are different groups of this bacteria, and correspondingly different vaccines: a MenB vaccine, which is offered to babies at two, four and 12 months; a Men C vaccine, offered to infants at 12 to 13 months; and a MenACWY vaccine, which is offered to young people between the ages of 14 and 25.

Pneumococcal bacteria can also cause meningitis and septicemia. A pneumococcal conjugate vaccine (PCV) protects against the 13 strains that most commonly cause disease, and is offered to babies at 12 weeks and 12 to 13 months.

A pneumococcal polysaccharide vaccine (PPV) is offered to anyone aged 65 years and over. While it protects against more strains than the PCV (23 rather than 13), it is only effective for a limited period and isn't effective in children under the age of two.

Other vaccines available include Hib, which protects against Haemophilus influenzae type b bacteria which, prior to the introduction of the vaccine, were once the most common cause of bacterial meningitis in children under the age of five, and the BCG, which offers protection against tuberculosis meningitis. The MMR vaccine, while protecting against measles, mumps and rubella, is also important as mumps was a common cause of viral meningitis in children before this vaccine became available.

Spotting the signs of meningitis in children 

Because small children are less able to verbalise their discomfort, and because vaccinations don't protect against all types of meningitis, parents and carers need to be alert to the signs of meningitis, even if their child is vaccinated.

"Symptoms can develop suddenly and usually involve rapid deterioration," says Dr Safia Debar. "Additionally, not all symptoms may be present at the same time; nor will they necessarily occur in a specific order. Symptoms relate to the inflammation of the protective covering of the brain with general infection, and sepsis which is when the infection enters the bloodstream."

She urges parents and carers to follow their instincts and seek prompt medical attention. "Do not wait for a rash or drowsiness to seek help," she says, adding that signs to be aware of include fever, lethargy, stiffness, vomiting, loss of appetite and a dislike of bright lights. Where a rash is present, try rolling a glass over it to see whether or not it fades. If it's still red, that's a warning sign. In babies, you may also notice that the fontanelle, the soft spot on the top of their head, is swollen, or bulging.

How to protect your child from meningitis

"Ensure your child receives the recommended vaccinations, including those against common meningitis-causing bacteria and viruses," says Tang. "You should also encourage good hygiene to reduce the risk of viral infections and teach children proper handwashing and hygiene etiquette." Further precautions include minimising contact with individuals who are coughing or sneezing, as meningitis can be transmitted via droplets, even from an otherwise healthy person. He also advises staying informed about meningitis symptoms, transmission and prevention strategies.

If your child exhibits symptoms, seek immediate medical attention. "If you are concerned about symptoms, you can call NHS 111 or your GP for help and advice," says Donovan. "However, if someone is ill and getting worse, you should call 999."

"Inform healthcare providers of your child's symptoms and any recent illnesses," says Tang. "Be assertive in expressing your concerns and share specific symptoms and observations. Request tests, including blood cultures and lumbar punctures – and if you feel your concerns are not being taken seriously, seek a second opinion or consult specialists."

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