Tuberculosis: what are the symptoms of TB infection, and how do they differ from Covid - amid rising cases

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The Covid pandemic has delayed diagnosis and treatment of tuberculosis leading to a rise in undetected cases in the UK

A persistent cough and fever should not be instantly dismissed as Covid as the symptoms could actually be a sign of tuberculosis (TB), a top UK doctor has warned.

Dr Jenny Harries, chief executive of the UK Health Security Agency (UKHSA), said that the delay to diagnosis and treatment during the coronavirus pandemic has increased the number of undetected cases.

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Tuberculosis mainly affects the lungs and can cause a persisten cough (Composite: Kim Mogg / JPIMedia)Tuberculosis mainly affects the lungs and can cause a persisten cough (Composite: Kim Mogg / JPIMedia)
Tuberculosis mainly affects the lungs and can cause a persisten cough (Composite: Kim Mogg / JPIMedia) | Kim Mogg / JPIMedia

Figures show that the decline in TB up to 2019 now appears to have reversed, with cases increasing by 2.4% in England, rising from 4,615 in 2018 to 4,725 in 2019.

TB cases fell in 2020, likely due to people staying away from the NHS during lockdown, but infections then rose by more than 7% in 2021.

The bacterial infection can be successfully treated with antibiotics, but in some cases it can be life-threatening.

Anyone who suffers with a persistent cough or fever, particularly those who are at higher risk of catching TB, are being urged not to dismiss their symptoms as coronavirus.

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A cough that usually has mucus and lasts longer than three weeks can be caused by a range of issues other than Covid, including TB.

Dr Harries said: “TB is curable and preventable and now is the time to get our elimination efforts back on track.

“Despite significant progress towards elimination in recent years, tuberculosis remains a serious public health issue in the UK.

“With treatment, most people will make a full recovery, but delayed diagnosis and treatment, particularly during the pandemic, will have increased the number of undetected TB cases in the country.

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“It is important to remember that not every persistent cough, along with a fever, is Covid-19. A cough that usually has mucus and lasts longer than three weeks can be caused by a range of other issues, including TB.

“Tuberculosis develops slowly, and it may take several weeks, months or even years after you were infected before you notice you’re unwell.

“Contact your GP if you think you could be at risk so you can get tested and treated.”

What are the symptoms of tuberculosis?

Tuberculosis is a bacterial infection that is spread through inhaling tiny droplets from the coughs or sneezes of an infected person.

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It mainly affects the lungs but it can cause damage to other parts of the body, including the abdomen, glands, bones and nervous system.

People are at a higher risk of catching TB if they:

  • are in close contact with a person known to have the disease
  • migrate from countries with high rates of TB
  • are homeless
  • are addicted to drugs
  • have a weakened immune system
  • are in prison

Symptoms of TB vary depending on which part of the body is infected and it can take several weeks before you start feeling unwell.

Sometimes the signs will not start to show until months or even years after the initial infection, while in other cases it will not cause any symptoms at all.

General symptoms of TB typically include:

  • a persistent cough that lasts more than three weeks and usually brings up phlegm, which may be bloody
  • loss of appetite
  • weight loss
  • a high temperature
  • night sweats
  • extreme tiredness or fatigue
  • breathlessness that gradually gets worse

Most TB infections affect the lungs but it can also develop in other parts of the body, such as bones and joints, the digestive system, and the nervous system, although this is less common.

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TB affecting other parts of the body is more likely among people who have a weakened immune system.

Symptoms of TB outside of the lungs can include persistently swollen glands, abdominal pain, confusion, a persistent headache, seizures, and pain and loss of movement in an affected bone or joint.

The NHS recommends seeing a GP if you have a cough that lasts more than three weeks, or you cough up blood.

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