Tuberculosis

Tuberculosis is an infectious disease caused by the tuberculosis bacterium (Mycobacterium tuberculosis).

The most common symptoms of tuberculosis are general symptoms (fever, fatigue, listlessness, weight loss, low-grade fever, and night sweats) and/or symptoms caused by the location of the disease process in the lungs or other organs, such as coughing up blood, chest pain, and shortness of breath in the case of pulmonary tuberculosis.

Infection with tuberculosis bacteria almost always occurs via the respiratory tract (aerogenically), through contact with a patient with active (contagious) pulmonary tuberculosis.

If open pulmonary tuberculosis is diagnosed, the infectious period is determined on a case-by-case basis. In general, this is from the onset of coughing symptoms until several months after the start of treatment.

8 weeks to lifelong. Illness usually occurs within 2 years of infection, but it can also take decades.

There is a vaccine, the Bacillus Calmette-Guérin (BCG vaccine). Because TB is rare in the Netherlands and the vaccine only offers partial protection, vaccination is not recommended as standard practice.

Unprotected contact with a patient with a contagious form of TB.

In situations where there may be unidentified infection or where concentrated TB cultures are handled, such as pathology (particularly autopsies) and laboratories where TB is cultured.

• In older people.
• People with underlying chronic conditions.
• People with reduced immunity.

Prevented by a strict isolation policy.

See SRI guideline on isolation. Depending on your umc's isolation policy: gloves, apron, goggles, and FFP2 mouth-nose mask.

After unprotected exposure, a contact investigation is initiated, in which contacts are tested with a Mantoux or IGRA after at least 8 weeks.

• SRI guideline on isolation
• TB | LCI guideline RIVM
• Commission for Practical Tuberculosis Control | RIVM