More diseases in Germany: Tuberculosis is back
In Germany, more people are once again suffering from tuberculosis. Many refugees are infected. But the disease is well treatable.
More people are once again suffering from the infectious disease tuberculosis.
Photo: imago/Science Photo Library
Mönchengladbach. Even in the middle of the 19th century, every fourth adult man in Germany died of tuberculosis (TBC), also known as consumption. Today, the disease has almost completely disappeared from the consciousness of Germans. However, tuberculosis is still one of the most common infectious diseases worldwide, alongside HIV and malaria. According to the World Health Organization (WHO), 9.6 million people were newly infected in 2014 and 1.5 million died.
According to the Robert Koch Institute (RKI), patient numbers have been rising again in Germany for a few years now. Some of those infected are refugees who have been infected either in their home country or during the exhausting flight. According to RKI, 4533 tuberculosis cases were registered in Germany in 2014, 278 more than in 2012, the year with the lowest level to date. Half of all tuberculosis patients were born abroad. In 2015 the number increased once again: 5865 tuberculoses. Is consumption returning?
How does tuberculosis develop? Tuberculosis is an infectious disease. The trigger is the bacterium Mycobacterium tuberculosis. “If you inhale it, your lungs often fall ill first. The infection then spreads to the body,” said Dr. Andreas Meyer, head physician at the Clinic for Pneumology (Pulmonary Medicine) and head of the Lung Cancer Centre at the Maria Hilf Clinic in Mönchengladbach. In this case, the disease is pulmonary tuberculosis. However, one has to spend more than eight hours in a room with someone who is suffering from open TB in order to become infected. Dr. Charles Lange, a resident lung specialist in Düsseldorf, adds: “In principle, tuberculosis can affect any organ. For example, there are rare cases of lymph node or bone tuberculosis. How can TBC be recognized? One coughs, has an elevated temperature and feels weak, because the disease consumes the body – hence the name consumption,” explains Lange. Chief Physician Meyer cites night sweats as a typical symptom.
According to the experts, the rare variants, such as bone TB, can cause physical damage such as fractures. Doctors identify TB with the help of blood or skin tests, X-ray examinations of the lungs and bacteriological analyses.
Is it a dangerous disease? Yes and no. Chief physician Andreas Meyer stresses that healthy and well-fed people do not necessarily die from it. “It is important that tuberculosis is diagnosed and treated. Otherwise, according to lung expert Charles Lange, the slowly progressing infection can cause considerable damage to the lungs – up to fatal organ failure.
The TBC has lost its horror because we can heal it within half a year,” explains Meyer. Charles Lange explains: “In the case of uncomplicated (lung) tuberculosis, four different drugs are taken over a period of two months, two of them for a further four months. At first the patients come to the clinic, later they are cared for at home. Two to three weeks after the start of therapy, they are usually no longer contagious. In Germany, there is also a system that prevents the spread of the disease. Andreas Meyer: “Every health authority has a TBC welfare office to which an illness must be reported. Those who do not want to be isolated and treated are forced to do so by law.” The environment of the patients is also being investigated.
How can you prevent? A healthy lifestyle with alcohol in moderation can be a form of prevention, according to Chief Physician Andreas Meyer. “A stable state of health is a good way of countering the low risk of infection.” According to the experts, the risk of being infected by refugees or migrants entering Germany is negligible. “Whoever arrives is examined for blood. In addition, there is screening by X-ray of the lungs in order to isolate and treat patients immediately,” says Lange.
Are other countries more affected? Yes. Which is a reason for rising numbers in this country. Because refugees or immigrants often come from areas with a high risk of tuberculosis, where hygiene conditions are poor and people are poorly fed. These include Russia, Asia and Africa. People are often treated inadequately and too briefly.
Andreas Meyer: “The new cases in Germany are generally not German citizens, but refugees between the ages of 15 and 30 who become ill – but who are then also given comprehensive medical care. According to the German Leprosy and Tuberculosis Relief Association (DAHW), many people became infected during the exhausting flight and in the confines of the refugee camps. The immune system of the refugees is mostly stricken.