According to Weiss, 1.6 to 1.7 million people worldwide die of tuberculosis every year. Due to the coronavirus pandemic, the disease, with its often unspecific symptoms, has been diagnosed less frequently. According to the World Health Organization (WHO), the number of new diagnoses fell from 7.1 million in 2019 to 5.8 million in 2020, in contrast there was an increase of a good 100,000 deaths from tuberculosis in this period.
In Tyrol only low numbers of illnesses
In Tyrol, the disease was largely contained, in 1995 76 cases of illness were recorded, in 2021 there were only 27. According to Weiss, one reason for the decline is the better hygiene and living conditions. Tuberculosis used to be a disease of the “poor people” who lived in precarious hygiene and housing conditions and were undernourished.
In addition, there was no specific therapy until the 1960s. “The patients were sent to air therapy, for example to Hochzirl, they were placed in the sun and sometimes a pneumothorax was created so that the lungs collapse. It was hoped that this would heal the infection,” says Weiss, who is also director of the University Clinic for Internal Medicine II.
No big danger from people from other countries
Weiss does not see a major problem in the fact that some people flee or migrate from countries where tuberculosis is widespread. A significant increase in the number of diseases is not to be expected as a result. Healthy people would have an extremely low risk of contracting tuberculosis after contact with sick people. There is virtually no risk of infection outdoors.
A good immune system eliminates the pathogen immediately
A good immune system eliminates the bacteria on the spot, says Weiss. This is the case for 50 to 70 percent of people who come into contact with TB. In the remaining 30 to 50 percent of people who have come into contact with Mycobacterium tuberculosis, the immune system is not able to eliminate the bacteria immediately. Latent tuberculosis develops, which can be diagnosed with immunological tests.
With increasing age, a weakened immune system or through immunosuppressive therapy, latent tuberculosis can be reactivated and become active tuberculosis. According to Weiss, this applies to around five percent of people with latent TB over the course of their lives. The symptoms of active tuberculosis are initially very unspecific with night sweats, reduced performance, weight loss, chronic cough and fever and the disease progresses insidiously.
Treatment with extensive course of antibiotics
According to the Tyrolean infectiologist, several antibiotics must be taken at the same time for at least six months to prevent the development of resistance. Multi-resistant tuberculosis, which fortunately is not yet widespread in Austria, is treated for two to three years. With adequate therapy, however, the chances are very good that the disease will heal completely and never return.
According to Weiss, small children have the greatest risk of a severe course. Weakened and malnourished people are just as at risk as patients with untreated HIV infection or impaired immune function due to other diseases or therapies.