A few days ago, the School of Science and Arts of Jiangsu Normal University issued a notice stating that from August 21, 2019 to October 12, 2020, 22 cases of tuberculosis among students in the school’s Pan’an Lake campus have been discovered one after another. After CT screening, another 43 students had abnormal chest imaging, which required further diagnosis and exclusion.
We will leave aside the question of how the school allowed tuberculosis to spread for more than a year. However, the new crown, tuberculosis, plague, brucellosis that have emerged this year or nationally or regionally… Is 2020 really the first year of the biochemical crisis?
But in fact, apart from the new coronary pneumonia, several other diseases are really not too far away from us, especially tuberculosis that sounds very early and many people think it is about to be eliminated.
According to Liu Chao, an infectious disease physician at the Second Affiliated Hospital of Zhejiang University School of Medicine, The incidence of tuberculosis is about 60/100,000, ranking second in China’s infectious diseases, second only to family members. Viral hepatitis(93/100,000), higher than syphilis(about 30/100,000). About 80% of tuberculosis cases are tuberculosis.
The Academy of Sciences is not the first school to have an outbreak of tuberculosis in recent years. At the end of last year, many students from the Computer Department of Hebei Vocational and Technical College were exposed to tuberculosis; further on, the fourth middle school in Taojiang County, Yiyang City, Hunan Province also had a mass infection.
Breaking news and appalling numbers are sending a message that tuberculosis is not as far away as we thought.
coming back
From the nickname “White Plague”, it is not difficult to see the fear left by tuberculosis in the 17th to 20th centuries.
During wars and famines, soldiers, civilians or nobles may be infected by Mycobacterium tuberculosis that had not been discovered at the time. These Mycobacterium tuberculosis come aggressively and often invade the lungs, causing fever, weight loss, coughing, phlegm, and a little bloodshot inside. If you cough badly, you might even spit out blood.
As beautiful as a lady of the Camellia, her indescribable charm is also inseparable from her morbid slenderness and flushed cheeks caused by fever.After Lin Daiyu’s handkerchief covered her mouth, the redness suddenly appeared in the white, and her illness was like Xizi wins three points. It was also believed by later generations that it might be inseparable from tuberculosis.
However, for patients with tuberculosis, these symptoms may not have anything to do with romance and delicacy, and are entirely a death threat from tuberculosis. Chopin, Chekhov, Xiao Hong, Lu Xun, Yu Dafu… But the list of celebrities who died of tuberculosis can list a long page. In China, tuberculosis used to be called tuberculosis. At its peak, “ten tuberculosis and nine deaths” is not an exaggeration.
On the one hand, malnutrition was very common at that time, people’s immunity was low, and sanitary conditions were generally poor, and bacteria flourished; on the other hand, the medical level was underdeveloped, and the diagnosis of tuberculosis Not clear, let alone treatment.
After all, before German bacteriologist Robert Koch discovered Mycobacterium tuberculosis in 1882, these sick and pale people did not know why they contracted the disease, and doctors were helpless.
Robert Koch, discoverer of tuberculosis
In the next few decades, the X-rays discovered by Roentgen gave a basis for the diagnosis; in 1945, the birth of the special drug streptomycin made tuberculosis cureable. The BCG vaccine to prevent tuberculosis was also born during this period.
The improvement of prevention, diagnosis, isolation, and treatment capabilities has gradually faded tuberculosis out of the sight of the public in developed countries and regions. This kind of contagious disease that has once made people heard of it seems to have been trapped in the era of war and famine, and now in India, Africa and other regions.
But the high incidence of tuberculosis in economically underdeveloped areas does not mean that economically developed areas are spared. In recent years, outbreaks of tuberculosis have occasionally occurred in the United States and the United Kingdom. Pulmonary tuberculosis is “making a comeback”, this is the wording of the WHO.
Specifically in China, there are still 770,000 in 2019Among patients with tuberculosis, 2,990 died. The numbers may not be shocking, but among the statutory infectious diseases in my country, the number of deaths caused by the disease is second only to AIDS.
The alarm bell was faintly sounded again.
Still pay attention to
In fact, the infectiousness of tuberculosis has never diminished. The main source of infection of the disease is tuberculosis patients, who expel bacteria into the air through coughing, sneezing, etc., and they will be directly transmitted through the respiratory tract in the form of droplets; and all people are generally susceptible to tuberculosis. .
Generally speaking, exposure to tuberculosis does not necessarily mean that we will be infected with tuberculosis. Normal immune function can help us eliminate the bacteria, or suppress its activity in the body, so that we can live with tuberculosis for a long time.
Schematic diagram of the pathogenicity of tuberculosis infection
But at the moment when the awareness of prevention and control is becoming weaker, even if only about 10% of the contacts become ill, it may cause an outbreak of tuberculosis, that is, the time distribution of cases is highly concentrated in a short time Most of them are caused by the same source of infection or transmission route. The gathering and enclosed places, such as schools and hospitals, are more susceptible places.
Yes The dataindicates that an untreated patient with excretion will infect 10 to 20 people around the conjugate within a year. In the pulmonary tuberculosis incident of the Academy of Sciences, the student reported that he was diagnosed with pulmonary tuberculosis in November last year.But in the following year, the school did not remind and control this.
The year that the news is covered is almost equivalent to allowing enough time for the disease to spread.
Of course, tuberculosis is not an incurable disease. According to Liu Chao, a small number of tuberculosis patients with strong immunity can heal themselves, and most tuberculosis cases can be cured by drugs such as isoniazid, rifampicin, ethambutol, and the treatment cycle is generally at least 2 Months; and the patient can return to collective life after healed, and generally there will be no subsequent effects.
The signs of recovery include the disappearance of symptoms such as fever and cough, CT influence indicating the disappearance of the lesion and the negative sputum bacterial culture.
But you must know that the damage to the liver caused by the treatment of tuberculosis is also objective. And it is worth noting that the probability of infection in cured patients is almost the same as that of unaffected patients, “The virulence of Mycobacterium tuberculosis is relatively strong.”
At the same time, although the criteria for the recovery of tuberculosis include the disappearance of fever and hemoptysis, and the cavities in the lungs indicated by CT effects are gradually healed, Liu Chao told Huxi that there are still a small number of patients with cavities left in the lungs, leading to their cure Later, there will still be regular hemoptysis, which requires follow-up surgery to treat.
The worse situation may be that due to the failure to follow the principles of early, regular, full, appropriate, and combined medication, especially the phenomenon of random drug reduction and withdrawal, these patients are likely to develop drug-resistant tuberculosis For patients, not only will the treatment cost and cycle increase significantly, the cure rate will drop to 52%, and the infectivity will also be greatly enhanced.
Because of this, both official agencies and ourselves need to re-evaluate the importance of tuberculosis.
As far as we are concerned, we don’t need to mention good living habits such as frequent hand washing, ventilation, and exercise. We should also pay attention to symptoms such as persistent dry cough, mild fever, fatigue, loss of appetite, and expectoration of sputum, so as to seek medical attention as soon as possible. Once the diagnosis is confirmed, there is no need to panic, but you should actively isolate and return to collective life after recovery, and close the transmission channel.
In addition, while preventing and preventing, we don’t need to be biased against tuberculosis patients. As mentioned earlier, after recovery, they are no different from others.
I’m Shi Sanxiang, the author of this article. I want to know everything about medical care. Welcome all kinds of gossips in the industry. WeChat: handadiya ( Add WeChat please prepareNote name, company, position)