There are many infectious diseases for which living abroad increases a person's risk factor, but tuberculosis (TB) may be one of the most insidious. It can masquerade as the flu, allergies or even cancer. People working and living abroad must be tested regularly.
What is Tuberculosis?
According to the American Centers for Disease Control and Prevention (CDC) fact sheet, TB is an infectious disease caused by the bacteria Mycobacterium tuberculosis. After infection, it is not uncommon for the slow-growing disease to take months before tests show positive. People who suspect they have been exposed to TB should wait several weeks to be tested.
Untreated, TB can be fatal. In fact, it was once the leading cause of death in the U.S. However the number of people in America with TB has been declining since 1993. Globally, the numbers are a little scarier. According to the CDC website, each year almost nine million people become infected with tuberculosis. Worldwide, one out of every three people are infected, and each year more than two million deaths are related to TB. Expats need to understand the scope of this threat.
TB Symptoms – How to Know When to See a Doctor
In many cases, TB symptoms are evident before the patient is suspicious of infection. The following symptoms are generally true of TB:
- fever
- chills
- weight loss
- fatigue/weakness
- lack of appetite
- sweating, especially at night
These symptoms are the same as for many other illnesses which makes diagnosis more difficult without testing. Not knowing exactly what is wrong, expats in countries where medicines are not as controlled as in the US may decide to take an antibiotic to combat what seems to be an infection. This is very dangerous because there are now drug-resistant strains of TB that are extremely difficult to treat.
The symptoms of active tuberculosis vary, depending on the location. Lung or pulmonary TB, the most common type, may include:
- a cough that lasts longer than three weeks
- coughing up blood or sputum which is a mixture of saliva and mucus
- chest pain
How is a Diagnosis of Tuberculosis Decided?
A tuberculosis skin test often called a PPD – which must be read by medical personnel 48-72 hours after administration – is widely used as a preliminary means of identifying people who have been infected. Positive PPDs are often followed by a chest x-ray. Also, there are several new blood tests for TB which may not be available internationally. Three sputum samples, each taken more than eight hours a part, and cultured for six to eight weeks is the gold standard for diagnosing active pulmonary TB.
When TB attacks another part of the body, the diagnosis must be made with a biopsy. In a laboratory setting, pathologists will apply special dyes that make the TB cells easy to identify.
The Bacille Calmette-Guérin, commonly called theBCG, is a vaccination to prevent tuberculosis. It is available primarily in countries where TB is rampant. People who have been vaccinated will usually have a positive PPD however the BCG will not affect the results of a chest x-ray or blood test for TB.
Expats, especially those living in developing nations, must realize that contracting tuberculosis is a very real threat. With TB symptoms masquerading as many other less harmful illnesses a diagnosis requires medical professionals. Self-medication may lessen the impact of TB symptoms and increase the risk of the disease becoming drug resistant. For more information on expat health risks see Expats are Exposed to Unusual Infectious, Communicable Diseases.
Disclaimer: The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact a doctor for advice.
Mistie Shaw - Writing for nearly half a century, Shaw's interests and education meander from music to the military, and from faith to fun.
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