Year 2013: is tuberculosis curable?
Can tuberculosis be cured in the second decade of the 21st century? What is the most common infection today? Is the prevalence of this disease increasing or decreasing? These and other questions for MedPulse are answered by TB doctor Leonid Potapov
– How is a modern Russian most often infected with tuberculosis?
– In the vast majority of cases, tuberculosis infection occurs in childhood. That is why already in the maternity hospital, on the 4-7th day after birth, infants are vaccinated against this disease. It is believed that they provide protection against tuberculosis for about seven years, so re-vaccinations are given to children at 6-7, and then at 14-15 years old.
– Nevertheless, in recent years, there have been more and more tuberculosis patients in our country. How can you explain this?
– First of all, the fact that no vaccinations, including anti-tuberculosis, do not give one hundred percent protection against infections and do not work throughout life. If in a family where there is a patient with severe tuberculosis, children and other adults are constantly in close contact with him, then a “breakthrough” of immunity occurs very often. But vaccination protects children from severe forms of tuberculosis, which previously led to death. This is tuberculous meningitis, miliary tuberculosis, in which there are multiple foci of inflammation in the lungs, which then spread to other organs. In previous years, such diagnoses sounded like death sentences. Now we are dealing with these forms of the disease, but the success of treatment depends on how quickly they are detected. – So you want to say that the child’s disease with tuberculosis should not cause severe anxiety in the parents? – This is more true for children who vaccinated. But now childbirth is in fashion at home, and no vaccination is done. Quite often, the so-called new Russians, naively believing that the money will provide them with protection from any illnesses, object to vaccinations, and we, unfortunately, cannot make them against the wishes of our parents. There are refusals for religious reasons. But especially mass rejections occur after people who are completely incompetent in medical matters take the responsibility of claiming in the media that the vaccines against tuberculosis have no effect. The price of such applications is very high: if vaccination of newborns is reduced by only 5%, then after this the incidence of young children, that is, up to three years, grows one and a half times
– Can you tell us about any positive developments that would clearly testify in favor of vaccination?
– Those people who lived in our country half a century ago probably remember how many hunchbacked, lame, blind, deaf people we had then. Bone tuberculosis, tuberculous meningitis, and other diseases associated with tuberculosis infection have made them such. Just then, we began to introduce anti-tuberculosis vaccines, and today we practically do not see such patients. This is the most convincing argument in favor of vaccination. – How can I find out that a child has contracted tuberculosis? – For this, annual tuberculin tests are conducted in kindergartens and schools. A positive response to such a test means that either the child is already sick with tuberculosis, or the infection has penetrated into his body and a disease can occur with the slightest adverse environmental factors. In the early nineties, using this diagnostic method, we identified 2 patients or sick per thousand tested children, and today we find already 7. The incidence in children is almost completely consistent with the epidemiological situation as a whole in the area where they live. We go to the families of such children and find parents or close relatives there, who often do not know that they are sick with tuberculosis.
– How great is the risk of infection in newborns?
– We are doing a lot of work to examine pregnant women and their environment. The fact is that after vaccinations, the immunity in infants is formed within two months, and even if after vaccination the baby gets into a family where there is such a patient, the probability of infection is almost one hundred percent. All measures are being taken to isolate children from sick relatives for these two months. During this period, the mother and baby can live, for example, with their parents, and if the mother is sick, we put the child in a children’s hospital. But, unfortunately, not all adults understand the importance of such examinations. There are times when they are abandoned, endangering the health of the child whom they look forward to
– And what about adult tuberculosis?
– In adults, tuberculosis can be for two reasons. One of them is an exacerbation of a disease that a person acquired in childhood. That is, he was infected, but not sick.