“Tuberculosis was and still is a disease of the poor but you may also contract it when you are overworked and employed at a government ministry, for example. All depends on your susceptibility to TB and on who you come into contact with,” said Prof. MUDr. Jiří Homolka, DrSc., head of the First Department of Tuberculosis and Respiratory Diseases of the Charles University First Faculty of Medicine and the General Teaching Hospital, at an event to mark World Tuberculosis Day.
Tuberculosis still presents a global threat but does not get sufficient media attention, being overshadowed by more attractive topics. If you live in the Czech Republic, your chance of contracting the disease is a hundred times smaller than in India, China or Indonesia. Ninety percent of all TB cases occur in developing countries but TB is tricky in that you may catch it anywhere in the world if you stay in long term contact with someone with asymptomatic tuberculosis. In Europe, the situation is most severe in Romania, Moldova and Russia.
“When I ask students at the First Faculty of Medicine to guess the annual number of newly diagnosed TB cases in the Czech Republic, fifth-year students say fifty. Our latest data come from 2009 when we recorded 710 cases in this country. It is a decrease compared to the 879 cases in 2008 but there is a marked discrepancy between the population’s awareness and reality,” Prof. Homolka says. He says he believes the public doesn’t realize the actual threat of the disease and sees TB as a “dinosaur”, an extinct species no longer around but whose petrified eggs are found from time to time.
“Tuberculosis should be given permanent attention – because even though the Czech Republic has a sophisticated monitoring system of the disease, it remains to be seen how immigration will affect the development of the situation,” the expert says, adding that “the fight against TB began in the otherwise unfortunate year 1948 when the state decided to take action against the disease. Since then there has been a steady drop in the number of cases, with the exception of the years immediately after the Velvet Revolution. On November 1, 2010, obligatory BCG vaccination was officially discontinued and is only administered on a selective basis in high risk groups of newborns. It will take time for the effects of the change to become apparent and it is impossible to clearly predict the further development of the spread of TB in the Czech Republic.”
At present, in the under-20 group, TB is diagnosed mostly in patients who had not been vaccinated. Paediatricians must be prepared for the fact that this diagnosis may occur more frequently in the future. “As a parent, you need to realize that vaccination protects the individual against serious forms of tuberculosis and works as a prevention. If children are vaccinated, they are protected during the most vulnerable period of their lives. The decrease in the number of TB cases however is mainly due to early diagnosis, isolation and treatment,” Prof. Jiří Homolka concludes.
Prof. MUDr. Jiří Homolka, DrSc.
is a leading expert in the field of pulmonary diseases. He is a member of the European Respiratory Society (ERS), the American College of Chest Physicians (ACCP) and the German Society for Pneumology (DGP).
Translation: Pavla Horáková