A persistent cough, slight fever, night sweats – it all sounds pretty harmless at first. But these symptoms can also indicate the presence of one of the most dangerous infectious diseases in the world.

Tuberculosis is not only found in developing countries: more than 170,000 new cases were reported in Europe last year – and the number is rising again. In Luxembourg, 48 people were infected with tuberculosis in 2023. 
 
Tuberculosis is an infectious disease caused by bacteria. It usually affects the lungs, is contagious and transmitted via droplets. Those who are physically weakened or chronically ill are particularly at risk.

For example, HIV, drug addiction, alcoholism and diabetes can increase the risk of infection, as can taking medications that suppress the body’s immune system. 

How does an infection show up? 

Tuberculosis develops very slowly. The bacteria only divide about once a day. By way of comparison, bacteria in the gut divide every ten minutes.

It can therefore break out even after years if the affected person is weakened, for example. The symptoms mentioned above may occur in the first six to eight weeks after infection: cough, night sweats and slight fever.

In the later stages, the symptoms may become more pronounced: increased fever and coughing with green or bloody sputum.

Weight loss is another of the symptoms of what we also know as “consumption”. In some cases, however, the disease remains asymptomatic. 

We speak of “closed” tuberculosis when the centre of infection in the lungs is encapsulated. There is no risk of infection in this case. In the case of “active” tuberculosis, bacteria can be transmitted by coughing.

Tuberculosis can spread to other organs such as the kidneys, brain or bones – especially in immunocompromised persons.  

Multi-resistant pathogens complicate therapy 

Tuberculosis pathogens can lie dormant in the body for many years without causing an outbreak of the disease – this is referred to as latent tuberculosis.

Experts estimate that around a quarter of the world’s population is infected with mycobacterium tuberculosis, but only a small proportion actually develop the active disease.

Older people are particularly prone to it, having possibly been infected decades earlier.

The World Health Organization (WHO) estimates that around 10% of people with latent tuberculosis develop active tuberculosis during their lifetime – often not until they reach retirement age, when the body’s defences are weakened.

Preventive treatment may be useful in certain cases to reduce the risk of reactivation.  

If an infection is suspected, a blood sample is taken. There is also a skin test. However, both of these can produce false results. A lung X-ray can provide information about whether tuberculosis is present. If the infection is confirmed, this must be reported.  
 
Tuberculosis can be treated effectively with a combination of different antibiotics. However, there are more and more multi-resistant pathogens that complicate therapy.

Open tuberculosis is often treated on an inpatient basis in hospital. The standard therapy lasts for half a year. If the patient is intolerant or resistant, more expensive and less effective drugs are used, which can extend the treatment period to up to a year.