Communicable Diseases – Tuberculosis

At Iridia Medical, many of our paramedics work in oil and gas camps in Northern British Columbia, as such, we encourage them to be prepared for whatever they may come across in these remote regions.

Throughout the year, we profile various diseases and afflictions to help further their understanding in the hopes they will be prepared should they come into contact with one of these diseases.

This week we are profiling a known transmissible disease that an individual may encounter in their career as a paramedic, nurse or other health care provider. It is our hope that this profile will allow you to quickly diagnose common or rare diseases should you come across them.

What is Tuberculosis?

Tuberculosis is a common, and in many cases lethal, infectious disease. Tuberculosis is caused by Mycobacterium, bacteria which are spread through the air like the common cold. 

Tuberculosis typically attacks the lungs, but can also affect other parts of the body. Most infections are asymptomatic and dormant, but about one in ten dormant infections eventually progresses to become an active disease which, if left untreated, kills more than 50% of those so infected.

In the active stage, a person often shows symptoms of the disease. Active bacteria will usually infect the lungs or airways but may also affect several organs (lymph nodes, kidneys, etc).

Risks

Weakened immune system – A healthy immune system can often successfully fight TB bacteria, but your body can’t mount an effective defense if your resistance is low. A number of diseases and medications can weaken your immune system, including: HIV/AIDS, diabetes, kidney disease and cancer treatment.

International connections – TB risk is higher for people who live in or travel to countries that have high rates of tuberculosis, such as: Sub-Saharan Africa, India, China and Mexico. 

Poverty and substance abuse – If you are on a low or fixed income, live in a remote area, have recently immigrated, or are homeless, you may lack access to the medical care needed to diagnose and treat TB. Long-term drug or alcohol use weakens your immune system and makes you more vulnerable to tuberculosis.

Prevention

If you have active TB, keep your germs from spreading. It generally takes a few weeks of treatment with TB medications before you’re not contagious anymore. Follow these tips to help keep your friends and family from getting sick: Stay home, ventilate the room, cover your mouth and wear a mask.

Symptoms

For active TB, symptoms usually include swollen and sore lymph glands, weakness or feeling very tired, weight loss, lack of appetite, chills, fever, night sweats. For active TB in the lungs and airways (pulmonary TB), symptoms usually include a bad cough that lasts longer than three weeks, pain in the chest, coughing up blood or sputum (phlegm).

Sudden Cardiac Arrest is a Family Matter

We have previously highlighted the factors that put you at risk of coronary artery disease (see post here). Among these factors, we identified family history as one of the leading contributors to sudden cardiac arrest.

A new Danish study released in November 2012, has provided additional details, and demonstrates a direct link between family history and SCA.

Research indicates that relatives of young sudden cardiac death victims appear to have a much greater risk of cardiovascular disease than the general population.

During 11-years of follow-up and tracking sudden cardiac death victims, there were 292 incidents of cardiovascular disease among those with relatives who suffered sudden cardiac death, compared to 219 incidents in the background population, representing a 33 percent increase.

Researchers found the risks were particularly high when the relative who suffered cardiac arrest was younger than 35. The findings suggest a large hereditary component of sudden cardiac death.

Sudden Cardiac Arrest

“Since the cardiovascular conditions on which we focused are treatable, early identification of at-risk persons is potentially a life-saving action,” wrote Mattis Flyvholm Ranthe, MD, of the Statens Serum Institute in Copenhagen. “Our findings are the first of their kind and support the initiation of cascade screening in families experiencing a sudden cardiac death, with customization of screening based on the underlying condition suspected to have caused the death and family member ages.”

Many of the risks linked to sudden cardiac arrest include:

  • Smoking
  • Hypertension
  • Obesity
  • Diabetes
  • Sedentary lifestyle
  • Alcohol (more than one to two drinks per day)
  • Age (after 45 for men and 55 for women)
  • Being male (2-3 times the risk)

However, previous studies have shown numerous links to sudden cardiac arrest through genetic mutations, including primary arrhythmia syndromes (electrical malfunctions), cardiomyopathies (heart muscle deterioration), familial hypercholesterolemia (elevated cholesterol levels), and ischemic heart disease (poor blood supply to the heart).

Further Details

To explore the link between family history and sudden cardiac arrest, researchers performed a prospective, population-based cohort study using Danish national registries. They identified 470 individuals ages 1 to 35 years who suffered a sudden cardiac death from 2000 to 2006, and 3,073 relatives.

  • Compared with the general population, the relatives had a greater risk of developing cardiovascular disease during follow-up
  • First-degree relatives — parents, children, siblings — had a greater risk of cardiovascular disease compared with second-degree relatives, such as half-siblings, grandparents, grandchildren etc…
  • Risks were particularly high for first-degree relatives younger than 35
  • The risks among the relatives were greater when the initial sudden cardiac death was verified by autopsy.