Tuberculosis primarily affects the lungs but can also affect other parts of the body. It is transmitted via bacteria that are spread through small droplets of saliva in the air. The droplets can be released into the air when someone with active tuberculosis in the lungs cough or sneezes. However, tuberculosis is far less contagious than influenza or measles.
Many are infected with Mycobacterium tuberculosis but will never be sick with the disease. This is called latent tuberculosis. Latent tuberculosis cannot infect others. It is estimated that 1/3 of the world's population has latent tuberculosis, but only around 5–10 percent will develop the disease. The risk of developing disease increases if you have a weakened immune system because of poor nutrition, stress, other diseases, such as HIV or diabetes, or use special medications, such as immunosuppressive treatment. Latent tuberculosis can be treated with preventive treatment.
Many of the symptoms for tuberculosis can be quite general, and easily confused with other infections. Some also have very few or no symptoms in the initial phase of the disease.
Typical symptoms of tuberculosis are:
People with tuberculosis outside the lungs will not have cough but may have the other symptoms.
Diagnosis is made through a sputum sample. The bacteria in the sputum will be identified through microscopy, molecular tests or culture. In Norway you can also take an initial IGRA- blood test. Chest x-ray is also a useful diagnostic tool. In case of tuberculosis outside the lungs, the diagnosis will be done by taking other types of samples for testing. This can also be done for children.Some people with tuberculosis experience a delay in diagnosis causing more severe illness. In low burden countries like Norway, doctors often do not know enough, or do not think about tuberculosis.
You can be cured for tuberculosis! Tuberculosis treatment is long, but effective. Most people that are diagnosed and treated for tuberculosis, will be cured. This means that the antibiotics will kill the bacteria.
The current treatment is antibiotics for a minimum of 4- 6 months. Some of the key drugs are Isoniazid, Rifampicin and Ethambutol. The medicine often comes in the form of combination tablets.
Early and correct treatment is the best way to stop spreading the disease. The treatment duration is long- but it is essential to take the antibiotics daily as prescribed to avoid getting sick again, and to prevent the development of antibiotic resistance.
It is very important to complete the full length of the treatment, and it is a good idea for the patient to liaise with a family member or friend, or even a peer, that they can talk to and that can support them through the treatment period.
In Norway, it is required to stay for a few weeks in hospital in isolation until the tests show that the patient is no longer infectious. In Norway and some other countries, there is also a policy of Directly observed treatment (DOT) – also after discharge from the hospital. This means that health workers must observe that the patient takes the tablets. This is usually carried out through homebased care (“hjemmesykepleien”). Some people experience side effects, such as nausea, digestion problems, itching and rashes, and red urine. It is important that the treatment is not interrupted without the advice of the doctor, and regular check-ups and close communication between patients and health worker about the treatment, side effects and mental- and emotional wellbeing is important during the entire treatment period. It might also be relevant for family members and others to take preventive tuberculosis treatment.
For more information to people on tuberculosis treatment, there are brochures in several languages here.
In some cases, the tuberculosis bacteria can become resistant to the most common antibiotics. People that have been diagnosed with drug resistant tuberculosis should be tested to see which antibiotics that are still effective, and which ones are not. The treatment duration is much longer - up to 20 months, and some of the drugs have a higher toxicity. It is therefore an urgent need to prevent the development of drug-resistant tuberculosis through better and shorter treatment regimens for susceptible tuberculosis, and good socio- economic and psychological support for people on treatment so that treatment is not interrupted.
About 50% or more of people that are treated for tuberculosis, may continue to have some type of health problems and impairments. Most common is what is called post-tuberculosis lung disease (PTLD). Others may struggle with depression, fatigue, or pains. It is therefore important to continue regular check-ups with the doctor even after treatment is completed. Support from a psychologist may be useful, as well as physical therapy and rehabilitation. You can read more about tuberculosis associated disabilities here.
In Norway there is a mandatory tuberculosis screening program for immigrants and asylum seekers from high- burden countries. It is important to note that those who are diagnosed with tuberculosis will receive tuberculosis treatment for free, and it will not affect any legal issues regarding your stay in the country. For more information about tuberculosis in Norway, you can find information here, and brochures in many languages here.
If any questions, contact us.