The Weekly Dose: If you think you can never get TB, you're wrong
India has the dubious distinction of topping the list of countries with the most citizens suffering from tuberculosis.
Being number one at something isn’t always a matter of pride. India has the dubious distinction of topping the list of countries with the most citizens suffering from tuberculosis. One in four TB patients the world over is an Indian. If all the residents of Arunachal Pradesh and Goa were to contract the disease, they would equal the number of Indians who contracted it in just one year. And imagine every tenth one was a child. India loses Indians equivalent to the population of Udaipur to this illness, every year. Because on average, TB kills one Indian every minute.
When we come across these facts and figures, we read the first few lines, shake our heads in sympathy, and move on. Because while we all know, or know of someone who suffers from TB, we believe we ourselves will never fall prey to it.
We’re wrong. Here are some myths about TB that we need to shatter:
You’ve never had TB: While you may never have had the disease, chances are, the germ that causes it entered your body when you were a child. You may not have felt sick when it set up house in your lungs, because your body’s immune system tackled it, and contained it; but the germ may have continued to survive in your body. Up to 80% of all Indians harbour this latent form of the illness; while those who do not harbour it have a 10% chance of suffering from full-blown TB in their lifetimes, those who do, have a 10% chance every year.
You’re vaccinated, hence you’re safe: The little scar on your left (or right) upper arm Indicates that you received the anti-TB vaccine; almost every Indian child is administered it at birth. You read the numbers at the beginning of this column; how effective do you think the vaccine is at preventing TB?
The vaccine does not prevent the latent infection mentioned above, nor does it prevent its reactivation in the future. All it does is stave off more severe forms of the disease. You are not immune to tuberculosis.
Only ‘those people’ contract TB: The stereotype of poor, emaciated wretches coughing away to their deaths in dark hovels is firmly ingrained in most minds, and is secretly reassuring; we who are well-off and have a much better quality of life can never fall prey to TB, right? Wrong.
Shortly before he started shooting for the first season of Kaun Banega Crorepati, Amitabh Bachchan was diagnosed with tuberculosis. He was treated for a year and went on to become an ambassador for the war against TB. You may feel sure and confident that your persistent cough isn’t TB, but it’s better to phone a friendly doctor instead.
TB affects only the lungs: Here is a non-exhaustive list of the parts of your body that TB can hijack: Brain, bones, joints, intestines, liver, spleen, pancreas, kidneys, urinary bladder, uterus, ovaries, prostate, food pipe, voicebox, eye, ear, nose, heart sac, and blood vessels. Amitabh Bachchan had tuberculosis of the spine. One can even develop TB of the skin.
1 in 5 new cases of tuberculosis is centred in a part of the body other than the lung.
TB always shows up as a horrible wet cough: The images of tragic film characters suddenly coughing up blood and later dying of TB have convinced generations of movie buffs that if you don’t have a productive cough, you don’t have TB. While TB of the lung does announce itself with a persistent cough, all forms of TB make a low-key entrance with symptoms as vague as a mild fever, loss of weight and loss of appetite. Non-lung TB substitutes the cough with features as divergent as abdominal pain, inability to conceive, altered menstrual cycle, increased frequency of urination, difficulty in walking, severe headaches and a disoriented mind.
TB is always contagious: TB is principally transmitted by sputum coughed out from a patient’s lungs, which is dispersed in the air and then breathed in by someone else. While a single patient can infect up to 20 other healthy people, it is important to remember that these patients live with their loved ones, most of whom don’t become TB patients consequently. Recent research shows that only between 1.5-3% of people who have close contact with a TB patient, fall ill with TB themselves.
If TB patients can pass on their disease to only such a small fraction of people, why do we still treat them like they have the plague, and avoid them at all costs?
Private hospitals treat TB better: No matter how well-off or penurious you are, the medicines you need to take to snuff out the germs are the same, and are provided free of cost by the government, and need to be taken for the same period of time. In fact, bedaquiline - the first new anti-TB drug approved by the US FDA in 50 years - is currently available only at government hospitals.
There are shortcuts to treatment: Many patients begin to feel better after a few months of therapy and stop taking their medicines. This causes the germ - which hasn’t been fully eliminated - to adapt to the antibiotic onslaught and become resistant to it. Drug-resistant TB is exponentially harder to treat, has more severe symptoms, and causes more deaths.
1 in 10 patients of drug-resistant TB is someone who was treated for TB earlier but didn’t complete the course.
You have nothing to do with the TB epidemic: Have you ever walked up to a chemist shop with a cough, and bought antibiotics prescribed by no-one but yourself? These antibiotics are ineffective against TB, but make people feel temporarily better, and delay genuine anti-TB treatment. 1 in 3 Indians with TB-like symptoms is saddled with these antibiotics by a chemist (not a doctor). 1 in 5 takes a type that is similar to an anti-TB drug, which makes the germ resistant to the actual anti-TB drug.
You can’t prevent TB: Your body’s immune system needs proteins to manufacture an arsenal that can battle the TB germ; a high-protein diet can go a long way in bolstering your defences. Skipping meals is not only painful but also asinine. Poor nutrition increases the chances of the latent infection transforming into an active one, increases the severity of the disease, as well as the likelihood of relapse. Wake up a little earlier, and eat that breakfast!
TB is curable, but more importantly, can be guarded against. This World Tuberculosis Day, let’s become chowkidaars of a different kind.