For many people of a certain age, their first brush with TB would been at school standing in line for their BCG vaccination. At the time checking the size of the bump on my arm, it almost felt like a badge of honour. And then it was forgotten about.
This jab is now not routinely given in schools and the disease is largely seen as being from the Victorian era. Despite an incorrectly held belief that the risk has gone, cases are increasing, highlighting the need for continued protection.
“I caught PTB from a patient in my 20s when I worked in critical and acute care”
I can tell you from personal experience that pulmonary tuberculosis (PTB) is still very much around. In fact, it is on the increase and, as nurses, we all need to be alert to the disease and its dangers – for patients and ourselves.
I caught PTB from a patient in my 20s when I worked in critical and acute care. I spent several months highlighting my deteriorating health and symptoms to other health care professionals and my employer.
However, I had convinced myself they were symptoms of exhaustion and ‘just a chest infection’. I was oblivious to being infected and was only diagnosed 18 months later when I went for a routine health check as part of a visa application.
At this point, the disease was well established and within two hours I was in hospital in isolation and unable to continue in my role. This left me alone and without access to friends and family. I was very afraid and confused.
Finding out I was infected was a total accident, not knowing meant I could have passed it on to my patients and family, and made my recovery even tougher. It changed me, and it changed my nursing career.
The treatment was challenging, and I underestimated the effect this would have on me as a nurse. In each role I have undertaken, I have faced questions about my diagnosis, often stigma and disbelief that this ‘Victorian disease’ was still here. But it very much was – and is.
The Covid-19 pandemic highlighted more than ever the need to protect ourselves with PPE, but being so focused on one disease may mean we can miss the symptoms of others.
PTB is treatable and early diagnosis can lead to a recovery, but, as nurses, we often ignore our own symptoms, instinctively putting patients first.
Just like many of my colleagues then, and those in nursing today, I did not think I was at risk from a disease that had largely disappeared. I suppose I could consider myself to have been already vaccinated and I would be safe.
This came from a place of general complacency – that the disease had gone away or was only prevalent in certain countries.
This is far from the truth – cases are increasing in the UK and now sit above pre-pandemic levels with nearly 5,000 cases diagnosed last year alone.
With the lack of general testing, it is possible cases could be even higher, and people could be walking around, going to work and meeting up with loved ones none the wiser.
This obviously helps spread the disease, but also makes treatment more challenging when the disease finally presents.
There are things we can do to protect ourselves and our patients. This starts with attending regular screenings, being vigilant when we are treating those displaying symptoms, and wearing the correct PPE in situations where we could be at risk.
If somebody presents with the signs of PTB do not hesitate to test for it. They may have come from an at risk country, for instance. Use your instinct as well as your training.
Awareness days are a great starting point for discussion, but we need to embed protection as being routine, in our conversations with colleagues and employers.
As we learned so well during the pandemic, having the right PPE is vital in protecting ourselves from infection risk.
We should now not think twice about wearing it where there is a risk of infection, and we must demand it from our employer wherever we are working.
“By protecting ourselves we can better care for our patients”
Above all, we must look out for the signs and symptoms of PTB in ourselves and others. These can include a persistent cough, night sweats, loss of appetite, fatigue, and weight loss. These are often confused for flu or even Covid-19.
Around the world, nursing staff are part of the global fight against PTB, but we must not forget cases are here too in our patients and our colleagues. By protecting ourselves we can better care for our patients.
Infectious diseases have concerned mankind for generations but, as nurses, we can help remove the threat of this once nineteenth-century disease for good.
Dr Nichola Ashby, UK deputy chief nurse at the Royal College of Nursing