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The 7 Little-known Signs Of TB You Need To Know Amid 'resurgence' Of Nasty Victorian Disease

DURING the winter months, it's pretty common to have a lingering cough or be struck down with the flu.

But with the deadly Victorian disease tuberculosis (TB) seeing a resurgence in England, officials have urged Brits to be vigilant about its symptoms.

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The deadly infectious disease TB has seen a recent resurgence in EnglandCredit: Getty

TB is one of the most infectious killer diseases in human history and has started to surge globally for the first time in 20 years.

Figures from the the UK Health Security Agency (UKHSA) show that cases of the Victorian disease increased by over 10 per cent last year - from 4,380 in 2022 to 4,850 in 2023 .

This worrying surge has left health chiefs scrambling to "investigate the reasons" behind it.

TB is serious and can be fatal if untreated.

It tends to affect the lungs but can also have an impact on the tummy, bones, glands and nervous system.

Health chiefs have warned that the disease's symptoms might easily be confused with a cold or flu, and they urged anyone with a a persistent cough and fever to see a GP.

Dr Esther Robinson, head of the TB unit at UKHSA, said: "Not every persistent cough, along with a fever, is caused by flu or Covid-19.

She explained how to spot a cough that could be caused by TB: "A cough that usually has mucus and lasts longer than three weeks can be caused by a range of other issues, including TB."

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She urged anyone with these symptoms to speak to a GP.

Health Explainer: JN.1 Covid The 7 signs of TB to know

According to the NHS, the symptoms of TB include:

A persistent cough that lasts more than three weeks and usually brings up phlegm, which may be bloody

Feeling tired or exhausted

A high temperature and night sweats

Loss of appetite

Weight loss

Feeling generally unwell

But if TB spreads to other parts of your body, such as your lymph nodes, bones or brain, you may also have other symptoms like:

Swollen glands

Body aches and pains

Swollen joints or ankles

Tummy or pelvic pain

Constipation

Dark or cloudy pee

A headache

Being sick

Feeling confused

A stiff neck

A rash on the legs, face or other part of the body

It's possible to have TB in your body but have no symptoms - this is called latent TB.

If you have symptoms, this is called active TB.

People are at higher risk of the disease if they are in close contact with a person known to have the disease, travel to countries with high rates of TB, are homeless, are addicted to drugs, have a weakened immune system or are in prison.

A global threat

Globally, 7.5million people were diagnosed with tuberculosis in 2022 - the highest number ever recorded.

The World Health Organisation (WHO) said this was because many people were unable to get a diagnosis or receive treatment during Covid lockdowns.

A separate report found cases of drug-resistant TB had increased by three per cent between 2020 and 2021.

Experts that warned the disease could be overtaking Covid as a threat to the UK.

Professor Robert Wilkinson, who is trying to find a cure for the disease, said it's "inevitable TB will be the most deadly infectious disease in the world again".

The NHS stopped offering the BCG vaccine against TB to children in 2005, now only targeting only children who travel to badly-affected countries.

"The proportion of resistant TB is gradually increasing everywhere and that is a problem in Europe too", the Prof from London's Francis Crick Institute, told the Mirror.

Until now, cases of the deadly infection have decreased by about two per cent per year for most of the past two decades.

According to a report on TB by the World Health Organization (WHO) the disease killed nearly 1.6 million people in 2021 - making TB the second leading infectious killer after Covid-19.

Many people were unable to get a diagnosis or receive treatment during Covid lockdowns.

To make matters worse, cases of drug-resistant TB also increased by three per cent between 2020 and 2021, the report said.

In July 2022, Brits were urged to be on the lookout for signs of the deadly Victorian disease after an outbreak at a university in Wales.

Read more on the Irish Sun

Three students at a university campus tested positive for the illness - eight months after coming into close contact with someone who died from the disease.

Illnesses such as scarlet fever, measles and mumps have all risen dramatically since Covid began.

How can I protect myself against TB?

There is a shot to protect you against tuberculosis called the  BCG vaccine.

It's given during childhood and is currently the most widely used shot globally.

It is no longer offered to secondary school kids in the UK and instead only targets young children deemed most at risk.

The NHS recommends it for the following groups:

Babies who live in areas of the UK where TB is more common

Babies and children who live with someone who has TB

Babies and children who were born or lived in a country where TB is more common

Babies and children whose parents or grandparents were born in a country where TB is more common

People aged 35 and under who are spending more than 3 months in a country where TB is more common

People at risk of getting TB through their work, such as healthcare workers who work with people who have TB

Tuberculosis In Children: Expert Lists Its Risk Factors And Treatment Challenges

Tuberculosis (TB) remains a formidable global health challenge, affecting individuals across all age groups. While often associated with adults, children are not immune to this infectious disease, presenting a unique set of challenges in terms of diagnosis, treatment, and prevention. We spoke to Dr Gajendra Vikram Singh, Chairman, UP State Task Force (NTEP), Professor and Head, Department of Respiratory Medicine, SN Medical College, Agra, who shared insights on the same.

According to Frontiers in Pediatrics, an estimated 2,10,000 youngsters die from TB every year. It is important to note that only 35% of children who have an active TB infection are properly identified and treated; in most low-resource nations, this percentage is far higher.

Prevalence and Incidence

"TB continues to be a significant public health concern worldwide, with an estimated one million new cases reported annually among children aged 0-14 years. Although the burden of the disease is higher in adults, children constitute a substantial portion of those affected", said Dr Singh.

Transmission and Risk Factors

The transmission of TB occurs through the air, typically when an infected person coughs or sneezes. "Children face an elevated risk of contracting TB when living in close quarters with individuals who have active TB, especially in crowded or poorly ventilated environments. Additionally, factors, such as malnutrition, HIV infection, and other immunocompromising conditions increase a child's vulnerability to TB", added Dr Singh.

Also Read: Genital Tuberculosis: Expert Explains Its Impact On Fertility

Challenges in Diagnosis

Diagnosing TB in children poses a considerable challenge due to the nonspecific nature of symptoms. Symptoms often overlap with those of other common childhood illnesses, leading to delayed or missed diagnoses. Persistent cough, weight loss, fever, and fatigue are common presenting symptoms in children with TB.

Clinical Presentation

Dr Singh highlighted, "Children with TB may present with a variety of symptoms, and extrapulmonary TB (infection outside the lungs) is more prevalent in this population than in adults. Organs, such as lymph nodes, bones, and the central nervous system can be affected, making the clinical presentation more diverse."

Traditional TB diagnostic methods, such as sputum smear microscopy, may be less effective in children. To address this, molecular tests, chest X-rays, and tuberculin skin tests are commonly employed to aid in the diagnosis of paediatric TB.

Also Read: Cough That Lasts 2-3 Weeks Could Be Tuberculosis: Other Warning Signs To Help Identify TB

Treatment Challenges

Paediatric TB necessitates a distinctive treatment approach, involving age-appropriate formulations of anti-TB medications. Adherence to a prolonged treatment regimen can be challenging for children and their caregivers, requiring additional support and resources.

Preventive Strategies

Dr Singh said, "Bacillus Calmette-Guérin (BCG) vaccination is a crucial component of routine immunisation in many countries and provides some protection against severe forms of TB in children. Early identification and treatment of latent TB infection in children with known exposure are essential to prevent the progression to active disease."

Public Health Interventions

To effectively address paediatric TB, public health efforts should focus on reducing the overall burden of the disease. This involves improving living conditions, enhancing awareness among communities, healthcare providers, and parents, and integrating efforts into broader global strategies aimed at reducing the overall burden of TB.

Bottomline

Dr Singh concluded, "Tuberculosis in children presents unique challenges that require a comprehensive and multidisciplinary approach. By increasing awareness, improving diagnostic tools, and developing child-friendly treatment regimens, we can make significant strides in addressing the impact of TB on the paediatric population. Efforts to combat paediatric TB must be an integral part of the broader global strategy to control and eliminate this infectious disease."

[Disclaimer: This article contains information provided by the expert and is for informational purposes only. Hence, we advise you to consult your expert if you notice any symptoms of TB to get the necessary treatment.]

How T Cells Combat Tuberculosis

La Jolla Institute for Immunology (LJI) is working to guide the development of new tuberculosis vaccines and drug therapies.

Now a team of LJI scientists has uncovered important clues to how human T cells combat Mycobacterium tuberculosis, the bacterium that causes TB. Their findings were published recently in Nature Communications.

"This research gives us a better understanding of T cell responses to different stages in tuberculosis infection and helps us figure out is there are additional diagnostic targets, vaccine targets, or drug candidates to help people with the disease," says LJI Research Assistant Professor Cecilia Lindestam Arlehamn, Ph.D., who led the new research in collaboration with LJI Professors Bjoern Peters, Ph.D., and Alessandro Sette, Dr.Biol.Sci.

The urgent need for TB research

According to the World Health Organization, more than 1.3 million people died of TB in 2022, making it the second-leading infectious cause-of-death after COVID-19. "TB is a huge problem in many countries," says Lindestam Arlehamn.

Currently, a vaccine called bacille Calmette-Guerin (BCG) protects against some severe cases of TB. Unfortunately, BCG doesn't consistently prevent cases of pulmonary TB, which can also be deadly. Although there are drug treatments for TB, more and more cases around the world have proven drug resistant.

To help stop TB, Lindestam Arlehamn and her colleagues are learning from T cells. T cells are critical for stopping infections from spreading in the body. Instead of targeting an entire pathogen, T cells look for specific markers, called peptides sequences, that belong to the pathogen. When a T cell recognizes a certain part of a pathogen's peptide sequence, scientists call that area an "epitope."

Uncovering T cell epitopes gives scientists vital information on how vaccines and drug treatments might take aim at the same epitopes to stop a pathogen.

T cells take aim at a range of TB epitopes

For the new study, the researchers worked with samples from patients who were mid-treatment for active TB. These samples came from study participants in Peru, Sri Lanka, and Moldova. By looking at T cells in patients from three different continents, the researchers hoped to capture a wide diversity of genetics -- and environmental factors -- that can affect immune system activity.

In their analysis, the LJI team uncovered 137 unique T cell epitopes. They found that 16 percent of these epitopes were targeted by T cells found in two or more patients. The immune system appeared to be working hard to zoom in on these epitopes.

Going forward, Lindestam Arlehamn's laboratory will investigate which of these epitopes may be promising targets for future TB vaccines and drug therapies.

A step toward better diagnostics

The new study is also a step toward catching TB cases before they turn deadly.

Because Mycobacterium tuberculosis is an airborne bacteria, a person can be exposed without ever realizing it. Once exposed, many people go months or years without any symptoms. This inactive, or "latent," TB can turn into active TB if a person's immune system weakens, for example, during pregnancy or due to an infection such as HIV.

For the new study, the researchers also compared samples from active TB patients with samples from healthy individuals. The scientists uncovered key differences in T cell reactivity between the two groups. "For the first time, we could distinguish people with active TB versus those that have been exposed to TB -- or unexposed individuals," says Lindestam Arlehamn.

Lindestam Arlehamn says it may be possible to develop diagnostics that detect this tell-tale T cell reactivity that marks a person's shift from latent to active TB. "Can we use this peptide pool to look for high-risk individuals and try and follow them over time?" she says.

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