How to prevent a tubercular infection ?

Dr KK Pandey *

In our country, majority of the people are quite ignorant of the fact that tubercular infection (TB infection) is gradually assuming an epidemic form. Young male and female unknowingly are falling prey to tubercular germs and getting infected. If you discuss with your relatives, friends and neighbours about their health – related problems, you will be surprised to know majority of them had had received treatment for TB at one or the other stage of their lives.

Previously, the infection was restricted to alcoholics, drug addicts and a low socio economic strata of the society, but now all the organs of the society including upper middle class and rich people are succumbing to tubercular infection. The recently increased incidence of tubercular infection among rich young males and females is largely due to round-the-clock presence of a large battery of maids and domestic helpers inside the house. Sometimes personal drivers employed in big houses play an important role in spreading tubercular infection because car owners and their personal drivers both commute daily for long hours in a closed vehicle.

Why does a TB infection spread?

A germ named 'mycobacterium tuberculosis' is responsible for TB infection. In our country there are several reasons for spread of TB infection among our people. Lack of intake of balanced diet and resulting malnutrition there from due to poverty top the list of causes of tuberculosis. Due to inadequate consumption of protein in daily diet, the human body becomes very weak and unhealthy and this results into weakening of self-defence mechanism in the body. This weak defence system of the body makes easy the entry of TB germs and thus allows them to make the human body their home.

Besides malnutrition, if body's defence mechanism gets weakened due to some other coexisting problems like AIDS disease, regular and heavy intake of alcohol and drug addiction, the TB germs enter the body easily without any resistance.

How does a TB infection spread?

The germs of TB usually spread by air. A tubercular patient, whose phlegm contains TB germs, plays a great and most important role in its spread. If a TB patient having tubercular germs in his sputum coughs even once, he discharges in the air about 3000 TB germs. If such patients continue to cough within the four walls of their house, the other family members living in the same house are naturally bound to get infected with TB germs. Because of exactly the same reason the person who lives in slum areas or localities with poor hygiene and ventilation or closed and unventilated houses are more susceptible to catch tubercular infection very fast.

Domestic helpers and maids are potential source of tubercular infections

While appointing maids and domestic helpers in the house, one must get them medically examined and regularly subject them to medical examination every year. If a complete medical examination is not possible due to some reasons, the least one can do is to get their chest x-ray and sputum examination done before allowing them to work inside the house and show their investigation results to your family physician or a local physician and solicit his opinion. If your domestic helper or your driver is suffering from dry cough or while coughing passes out large amount of phlegm and spit out blood during coughing, do not sit idle and get the chest x-ray and investigation of blood and sputum and seek advice of your personal physician.

Be vigilant and watchful of your family members for a TB infection?

Suspect the possibility of TB infection, If anyone of your family members is suffering from fever with daily evening rise in body temperature, sweating , extreme fatigue, weakness, loss of appetite, loss of weight, and feeling of always being sick. Immediately subject him to investigations of blood and chest x-ray and show them to a local physician.

If any of your family member have a complaint of chest pain which increases in intensity after taking a long breath or pain appears below the shoulder during coughing or there is a complaint of breathlessness while walking or during sitting, one should suspect strongly about the possibility of T.B. infection and initiate steps in that direction.

Do not ignore a chronic cough

Sometimes if your office colleague or your neighbour has a complaint of cough with or without sputum or with or without fever, advise him to get the chest x-ray and sputum examination done and persist upon him to seek advice from a physician.

Living in a good house plays a long-term role in prevention of tuberculosis.

Always live in sun-lit and airy houses and each living room should have a continuous flow of fresh air.

Never live in dark and stingy room and ensure that each room has a sufficient amount of sunlight at least for sometime each day. Always remember the germs of tuberculosis are killed even with mild sunlight and surprisingly exposure to a strong sunlight completely eradicates the TB germs. Therefore if people spend more time each day in the sunshine they can insulate themselves from TB infection to a great extent.

Never make any alteration in the structure of your scientifically constructed airy and well sun-lit houses, so that free flow of air and sunlight should not be disturbed. Avoid overcrowding in a small room by large number of people.

This considerably reduces 'cubic space' of free air per person, thus resulting into a rapid spread of TB and other infections.

A good nourishing diet prevents tuberculosis

Every person should avoid malnutrition, always take balanced diet, food rich in proteins and vitamins and always take lot of salads and green vegetables. Remember malnourishment decreases significantly the fighting capability of the human body against invading germs. In this situation, T.B. germs get easy entry into an already debilitated and malnourished body.

Avoid narcotics and excessive use of alcohol

Please do not get addicted to alcohol or narcotics. Excessive intake of alcohol considerably lowers the defense system of body in such persons. Alcoholics or drug addicts easily fall victims to an onslaught of TB germs.

Your office colleague might turn out to be a source of tubercular infection

If you suspect that your family member or your colleague in the office is suffering from T.B. do not sit idle and must subject yourself to a skin test called 'MANTOUX TEST' or TB test. If this test turns out to be positive, consult a chest physician for further evaluation and preventive strategy.

A greater role for hospitals in preventing spread of tubercular infection

Managers and administrators of the hospital must ensure isolation or separate special ward or room for keeping TB patient where arrangement of cross ventilation and ultraviolet rays is there.

Government hospitals and dispensaries must ensure the regular and adequate supply of ant tubercular drugs in their medical stores because irregularity in treatment by a TB patient will lead to more spread of TB infection. If a TB patient does not take ant tubercular drug regularly this will lead to a dangerous conditions called MDR Tuberculosis.

Role of surgery in prevention of further spread of tuberculosis

If a tubercular infection had destroyed the lung partially or completely, immediately consult a Thoracic or a Chest surgeon and get the destroyed part of the lung removed through the operation otherwise the remaining healthy portion of the lung or the healthy lung of the other side will gradually be infected by T.B. and will lead to fatal complications.