BÜRGERINFORMATION

TUBERKULOSE
ENGLISCH
TUBERCULOSIS
Human pathogen information sheet

What is Tuberculosis is caused by bacteria. The pathogens mostly affect the lungs, where the first symptom they
tuberculosis? produce is coughing, but can also invade almost any other organ and cause severe illness. Usually,
however, the disease does not break out. In Germany, the number of tuberculosis cases had been receding
steadily for decades. Reasons for this include improved living conditions and effective treatments for the
disease. The number of cases reported annually has declined only minimally since 2009, however, and
actually increased significantly in 2015. These changes are the result of an aging population and the
movements of migrants.
Around the world, increasing numbers of tuberculosis strains are becoming resistant against the most
important medication for treatment. Resistant pathogens cause diseases that are more difficult to treat and
often remain contagious for longer.

How does Person-to-person

tuberculosis spread? Tuberculosis usually spreads by person-to-person contact.
In case of open lung tuberculosis, the patient mostly emits pathogens when coughing and sneezing. Minute
pathogen-containing droplet cores (known as “aerosols”) enter the air and can then be inhaled by others.
Tuberculosis is not particularly contagious: whether or not infection occurs depends on the length and
intensity of contact with the patient, and the susceptibility of the person to an infection.
Tuberculosis affecting organs outside of the respiratory system, e.g. bones, joints or lymph nodes, is usually
not contagious.
Via foodstuffs
In Central Europe, disease transmission via food such as raw milk can be largely excluded, since cattle
tuberculosis is now virtually non-existent in this region.

What symptoms With the lung affected (most common case)

do the patients show? The disease usually starts with non-specific symptoms such as fatigue and exhaustion. Fever, lack of
appetite with undesired loss of weight and night sweats may also occur. Typical symptoms include a
persistent cough, sometimes with bloody sputum and pain when breathing.
With other organs affected (more rarely)
If the bacteria spread in the body through the lymph or blood vessels, other organs may be affected as well,
such as lymphatic nodes, the pleura, kidneys or the urinary tract. Bones, joints, the spine, gastrointestinal
tract or the central nervous system are affected more rarely.
Miliary tuberculosis and meningitis (very rare)
Very rare but especially dangerous forms include miliary tuberculosis, where several organs are affected,
and tuberculous meningitis. Infants and toddlers, as well as persons with an impaired immune system are
at particularly high risk.
If recognised in time and treated properly, tuberculosis will usually heal without consequences.

What’s the incubation An infection can usually be detected 6 to 8 weeks after transmission. This does not mean that the person is
period – and how long sick, however – only that the immune system has encountered the pathogen. Only 5% to 10% of
adolescents and adults will fall ill after becoming infected. In children and people with weakened immune
are you contagious?
systems, this likelihood is around 20% to 40%.
There are three options after infection with tuberculosis pathogens:
1. In most cases, the disease will not break out because the body's defences control the pathogens or
render them harmless.

Status: April 2018 | Page 1

TUBERKULOSE
ENGLISCH
TUBERCULOSIS
Human pathogen information sheet

What’s the incubation 2. The pathogens remain dormant in the body at first. However, if the immune system weakens, the disease
period – and how long may still break out after years or decades. In children, active tuberculosis develops more frequently and
often in the first year after infection. Sick children often have no typical symptoms and their condition only
are you contagious?
becomes evident (if at all) because the child develops more slowly.
3. The illness breaks out.
Patients with open lung tuberculosis are contagious while they emit pathogens able to procreate in their
cough and they can be documented in the sputum. Once they are taking effective medication, patients are
usually no longer infectious after 2 to 3 weeks.

Who is most at risk? Persons at especial risk include those with close contact to patients with open tuberculosis of the lungs and
persons with immune systems that have been weakened (e.g. by an HIV infection or by taking medication
that suppresses the immune system) as well as diabetics, alcoholics and infants. The same applies to
persons who are drug addicts or homeless, since this often coincides with bad nutrition or bad hygienic
conditions.

What to do in case of Tuberculosis is subject to the rules of the German Prevention of Infection Act. The relevant health
illness? authority will take all required steps to protect others from the disease.
Patients who excrete tuberculosis pathogens with sputum are isolated while they are contagious. This
is usually done in the hospital, but may be done at home in coordination with the health authority.
Tuberculosis is treated with a combination of medications that are only effective together and must be
taken reliably for several months. The disease can be healed this way. Taking the medication
incompletely or not for long enough may cause the pathogens to grow resistant, i.e. that they no longer
react to these substances.

How can I protect See a doctor if a cough persists for more than three weeks. If the cough produces blood, then a
myself? medical opinion must be sought immediately. The sooner tuberculosis is recognised, the better can it
be treated.
Strictly observe the recommended hygiene measures of the treating facility.
Preventive treatment after contact with someone is recommended if this person is subsequently
diagnosed with an infection. It may prevent the disease from breaking out. Since young children are at
an increased risk of catching and developing the disease, preventive treatment should be started right
after contact even if infection cannot be documented yet. This can prevent either infection or the
further progress of the disease. The medication is prescribed by a doctor.
Important: A vaccine against tuberculosis has not been recommended in Germany since 1998.

Where can I find out Your local health authority can provide you with further advice. Since tuberculosis infections must be
more? reported, they will also have the latest information and be very experienced in dealing with the disease.
More (specialist) information is also available online from the Robert Koch Institute
(www.rki.de/tuberkulose) and the German Central Committee for Combating Tuberculosis
(http://www.dzk-tuberkulose.de/).
For more information on how hygiene can guard against infection, please visit the Federal Centre for Health
Education website (www.infektionsschutz.de).

Editor:
Federal Centre for Health Education, Cologne.
All rights reserved.

Drawn up in cooperation with the Bundesverband der

STEMPEL Ärztinnen und Ärzte des Öffentlichen Gesundheitsdienstes e.V. and
in coordination with the Robert Koch-Institute.

This citizens' information is offered for download free on the

website www.infektionsschutz.de.

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