Question 1: Is all TB disease contagious? How is tuberculosis transmitted? Tuberculosis is caused by the invasion of Mycobacterium tuberculosis into the body. The causative agent of TB is Mycobacterium tuberculosis, and it is spread mainly through the air via the respiratory tract. However, not all patients with TB are infectious. Generally speaking, only patients who have excreted tuberculosis are infectious (or open) and can spread the bacillus into the air and infect people around them. Of course, some TB patients whose sputum does not contain Mycobacterium tuberculosis may also be more or less infectious. It has been shown that an untreated patient with bacillus excretion can infect 10 to 20 people around him/her within a year. Generally, the infectiousness disappears after 2 to 4 weeks of standard anti-tuberculosis treatment. Mycobacterium tuberculosis is transmitted through the respiratory tract, mainly by droplet transmission and dust transmission. When coughing, sneezing or shouting, very small sputum containing bacteria is ejected from the patient’s mouth and nose, and this very small sputum is called droplets. The droplets containing bacteria can stay in the air for a long time, and then if a healthy person is close to the patient, the droplets containing bacteria may be inhaled into the lungs and infected, and this infection is called droplet infection. In addition, if the patient spits out the sputum containing bacteria on the ground, after the sputum dries, the tubercle bacillus will adhere to the dust, and when the wind is blowing or cleaning the ground, the dust containing bacteria will fly up and may be infected if inhaled into the lungs, which is called dust infection. Mycobacterium tuberculosis can also be transmitted through the digestive tract. If you eat leftover food or use dishes from infected patients, you may get infected with Mycobacterium tuberculosis, which can cause intestinal tuberculosis and peritoneal tuberculosis, etc. These methods are called dietary transmission and contact transmission. In addition, you can also get infected with Mycobacterium tuberculosis by drinking milk that has not been sterilized by boiling. Question 2: How do I know I have tuberculosis as early as possible? The onset of tuberculosis is generally slow, and the symptoms that you feel may sometimes be mild. Some patients are surprised to find out that they have TB unknowingly! There are even a few patients who have extensive tuberculosis lesions, with cavities in the lungs or blood in the sputum or hemoptysis, before they discover they have tuberculosis. There are also many patients who are discovered during medical examinations, such as military medical examinations, school medical examinations, employment medical examinations, and so on. So how can you know you have TB as early as possible? (1) Find out if there are any TB patients around you, especially the ones who are excreting the bacteria. Further clarify how close you are to the patient, how closely you interact, whether you talk, eat, work, study and live together regularly, etc. In general, such people are relatively susceptible to tuberculosis. (2) Pay attention to changes in your health status. Tuberculosis infection is not necessarily the same as the onset of the disease, but once the resistance is reduced, the original infected TB lesions in the body can easily become active and form TB disease. This situation is mainly seen in the recovery period after the disease, weakness after major surgery, diabetic patients, silicosis or long-term use of hormone therapy for other diseases. Therefore, you should pay attention to subtle changes in your body when you have the above-mentioned conditions, such as weakness, inability to eat, feverish palms, and poor sleep. (3) Know the symptoms of tuberculosis. Tuberculosis can have fatigue, weakness, low fever in the afternoon, loss of appetite, coughing and shortness of breath, coughing and coughing up blood, chest pain and tightness, night sweats, insomnia, and weight loss; lesbians can have irregular menstruation or even amenorrhea; children can have personality changes, irritability and irritability. However, tuberculosis can be asymptomatic in the early stage, and there can be no specific signs. Even if some patients have symptoms, they are relatively mild. Many people mistakenly think that they have a cold and are ignored. Question 3: How should TB patients pay attention to their daily life? There is a saying in China that “three parts of treatment, seven parts of nourishment”, where “nourishment” means nourishing the disease. Ensuring good rest and adequate sleep is a basic requirement for TB patients to recover. Patients with active tuberculosis should get at least 8 hours of sleep a day, rest in bed more often, and should not read too many books and newspapers, watch TV or play with computers. After the symptoms have been reduced by the treatment, the patient can be properly active and gradually increase the amount of activity, starting from indoor activities, walking, and gradually practicing qigong, tai chi, etc., step by step, never too hasty. For more strenuous activities, such as playing basketball, tug of war, soccer, jumping, etc. should be avoided. Pay attention to climate and environmental changes. In winter, pay attention to keep warm, wear a mask when you go out, and avoid going out in case of high winds, haze or bad weather. Sun exposure also has some benefits for the recovery of TB, especially extrapulmonary TB. However, there should be some restrictions for patients with active TB, because exposure to sunlight can cause hemoptysis, fever or disease progression. Mild TB patients should also try not to go to crowded places (e.g., fairs, shopping malls, etc.). Practice good personal hygiene. Bathe frequently, but the water should not be too hot and each time should not be too long to avoid excessive physical exertion or hemoptysis. Clothes and bedding should be dried and changed frequently. The room should be kept well ventilated. Question 4: What nutrition should TB patients pay attention to? As the old saying goes, “three parts of medicine and seven parts of nutrition”, where “nutrition” actually means nutrition. Tuberculosis is a chronic wasting disease, so attention must be paid to nutrition, not only to maintain normal physiological needs, but also to replenish the needs of consumption and repair caused by the disease. The nutrients required by the human body include: protein, sugar, fat, vitamins and trace elements. There are two kinds of proteins: one is animal protein, such as various kinds of meat, chicken, duck, fish, shrimp and eggs, etc.; one is vegetable protein, mainly from beans and peanuts, etc. The main source of sugar is grains and potatoes. Fat comes from animal oil and vegetable oil. Vitamins come from various vegetables, fruits, etc. Trace elements are mainly from milk, eggs, vegetables, beans, fish and shrimps, etc. All these nutrients are needed by TB patients. There is no specific rule on how much is good to eat, it varies from person to person. Generally speaking, staple foods, meat, eggs, vegetables and soup should be well-matched, with meat and vegetables, vegetables and soup, and eat enough to keep you from being partial. Question 5: Do TB patients need to “avoid eating”? TB patients do not need to “avoid eating”. Chicken, duck, fish, meat, eggs, seafood, vegetables, fruits, etc. can be eaten, but some irritating foods (such as spicy, salty, etc.) should not be eaten as much as possible to avoid aggravating the cough, which is not good for the disease. Tuberculosis patients should refrain from drinking alcohol, because alcohol can aggravate the damage of drugs to the liver, and alcohol can dilate blood vessels, and tuberculosis patients may cause hemoptysis after drinking alcohol. Of course, smoking is harmful and certainly not good for the recovery of the disease. Question 6: What can be done to prevent the transmission of tuberculosis? (1) Appropriate isolation measures should be taken for all patients with tuberculosis bacteria found in their sputum. (2) The place where infectious TB patients live should be disinfected with air regularly, the living room should be well ventilated, objects used by TB patients should be handled strictly, and their sputum should be disinfected carefully. As TB patients usually have to develop good hygiene habits, do not spit anywhere, and try not to go to public places to avoid infecting others. (3) Improve the body’s resistance by strengthening nutrition and participating in appropriate physical exercise. (4) Preventive treatment can be considered for high-risk groups with a history of close contact. (5) For newborns, BCG vaccination can be used to prevent tuberculosis.