People should remain on look out for TB symptoms

Media Release

20 February 2002

Ministry encourages people to remain on look out for TB symptoms

Recent reports about cases of tuberculosis reinforce the need for continual vigilance by the public and health professionals for symptoms of this treatable disease, says the Ministry of Health.

Good management strategies are in place in New Zealand for the treatment and control of tuberculosis, the world's leading infectious disease, said Director of Public Health Colin Tukuitonga.

"The risk the disease poses to the general public in New Zealand is low but it is important people are aware of the symptoms."

Tuberculosis can be treated with antibiotics, and if diagnosed early, most people recover completely. Each year in New Zealand there are about 400 cases of the disease.

"Tuberculosis affects the lungs in most cases, with a persistent cough the classic symptom of the disease. Anyone who has had a cough for more than two weeks should see their doctor, particularly if they have been in contact with someone who has tuberculosis, as the disease is contagious. Weight loss and night sweats are also common symptoms. "

Anyone experiencing tuberculosis symptoms should go to their doctor without delay.

Tuberculosis is a notifiable disease and medical practitioners are required to tell the nearest Medical Officer of Health when a case is suspected.

Dr Tukuitonga said local cases are handled well by public health service staff but it takes time to trace and treat the contacts of people with tuberculosis.

Treatment for tuberculosis involves specific antibiotics. The Ministry of Health's Guidelines for Tuberculosis Control in New Zealand 1996, and this is currently being revised.

There is a standard well established practice for tracing all contacts of a new tuberculosis case. Public Health Service staff identify all close and casual contacts of a case of tuberculosis by constructing a careful history. They then investigate potential 'at risk' contacts using a standard nationally approved protocol outlined in the 1996 guidelines.

"These are positive steps which have been taken to control tuberculosis, but the key factor is early detection of cases. People need to be aware of the symptoms of tuberculosis and seek medical attention."

END

For more information contact:
Anne-Marie Robinson,
Media Advisor,
ph: 04-496-2067
or 025-802 622
http://www.moh.govt.nz/media.html

BACKGROUND

How is tuberculosis caused?
Human tuberculosis is caused by Mycobacterium tuberculosis or Mycobacterium bovis.

How is it spread?
TB is spread by breathing in infected droplets that have been exhaled by someone with TB.

What are the symptoms?
When a person has tuberculosis they may lose weight, feel tired, sweat a lot at night, and cough regularly for more than two weeks often with thick phlegm, sometimes bloody.

What is the normal course of the disease?
The most common site of tuberculosis infection is the lung. There is usually a positive tuberculin test associated with disease and infection. The disease can progress at different rates. All cases can be cured with specific antibiotic treatment. If cases are not treated half will die from the disease. Some cases progress rapidly while other progress slowly.

How is tuberculosis treated?
Treatment is a combination of at least three antibiotics for a period of at least six months.

Is there any problem with drug resistance?
There are growing concerns about the increase in multi-drug resistant tuberculosis world-wide which is both difficult and expensive to treat. This is not a great concern in New Zealand at present but is a reminder of the importance of completing the required course of antibiotic treatment.

How many cases of tuberculosis have been reported recently in New Zealand? The rate of tuberculosis is low in New Zealand. There were 379 cases in 2001, 357 cases in 2000, 452 cases in 1999, 368 in 1998 and 330 in 1997.

How many people have died recently from tuberculosis in New Zealand?
There were nine deaths from tuberculosis in New Zealand in 2000, 10 in 1999, eight in 1998 and 15 in 1997. Tuberculosis is normally treatable, these deaths may have been in people who did not benefit from treatment.

What does the health service do to control tuberculosis?
The New Zealand tuberculosis control programme evolved from the enactment of the Tuberculosis Act 1948. Under this Act, the Medical Officer of Health in the regional public health service is given wide powers for the investigation and control of all tuberculosis cases and their contacts, including detention for treatment, if necessary.

Control of tuberculosis in New Zealand depends on effective detection, completed treatment, and vigorous contact tracing often involving extensive checks in families and communities. This ensures that people who have come into contact with someone who has tuberculosis can be offered preventive treatment or be regularly examined to ensure early detection of disease.

Close co-operation between health staff and patient is essential, and it is important that the course of antibiotics be completed to cure the patient and avoid drug resistance.

Ongoing work to control tuberculosis includes:
Early case detection
BCG vaccination to infants at risk
Treating the cases to ensure a cure
Contact tracing and the provision of preventive treatment
Education of health staff
Education of the public to the signs and symptoms of tuberculosis and need to seek medical attention
Provision of laboratory services
Appropriate guidelines for at-risk occupational groups
Appropriate screening of new immigrants to New Zealand.

Tuberculosis is easily treated and, if diagnosed early, the majority of cases have good outcomes.

Tuberculosis is a notifiable disease under the Tuberculosis Act 1948.

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