Every time a person exhales, sneezes, coughs, sings, or even talks, he or she sends out clouds of thousands of tiny drops of moisture. When someone talks for five minutes, sings for only a minute, or coughs once, that individual sprays about three thousand droplets into the air. And if the individual sneezes just one time without covering his or her mouth, approximately 40,000 droplets may spread as far as 3 feet (0.91 meters) away. After a sneeze, these tiny drops can hang in the air like fog.
The bacteria in the coughs or sneezes of a person infected with active tuberculosis hang in the air in the same way. A tuberculosis infection can start when someone inhales the germ Mycobacterium tuberculosis (Mtuberculosis) into his or her lungs. Each droplet from a sneeze or cough contains about three Mtuberculosis germs. The resulting infection is called pulmonary tuberculosis. The word pulmonary means "related to the lungs."
Tuberculosis typically spreads when an uninfected person inhales the infected droplets that the sick person exhales. This can happen to family members who spend a lot of time together. It can also happen to anyone who spends a lot of time in enclosed areas with groups of people. People at a high risk of catching tuberculosis include medical workers in hospitals or clinics, students in dormitories, convicts in a prison, and soldiers in military barracks.
Fortunately, tuberculosis is not as infectious as the common cold. You cannot catch tuberculosis by handling an infected person's clothes, bedding, or eating utensils. You will not get the disease if an infected person sneezes near you once or twice. You have to be exposed to a lot of germs over a long period of time in order for TB to develop. According to some scientists, if a healthy person stays with someone who has active tuberculosis twentyfour hours a day for sixty days, he or she has only a 50 percent chance of catching the disease.
A healthy person's body has many ways of protecting itself. The body's first line of protection comes from stiff hairs called olfactory cilia, which line the inside of the nose. Olfactory cilia trap dust, tiny particles, and microorganisms that people inhale from the surrounding air. Any swallowed germs travel to the stomach, where stomach acid kills them. Another germ barrier is mucus, the sticky fluid that lines the inside of the nose and the back of the throat. Mucus traps and collects bacteria. Mucus can build up in the lungs, where it becomes a slimy substance called sputum.
Mycobacteria that do make it past these defenses - nose hairs, stomach acid, and mucus - can be breathed into the lungs. From there, they can travel down the bronchioles all the way to the alveoli. Even then, the body continues to protect itself. The immune system, the body's natural defense against disease, sends out white blood cells to attack bacteria and other harmful invaders. The white blood cells that go after Mtuberculosis are called macrophages.
When tuberculosis bacteria invade, macrophages pile onto the invading germs like tacklers jumping on a runner with a footuberculosisall. These cells swallow tuberculosis germs, but they do not kill them all. Tuberculosis bacteria are hard to kill. Under the microscope they look like tiny sticks. They have a tough, waxy outer shell that protects them even when they are swallowed.
However, the macrophages isolate the bacteria from the rest of the body. The pile of cells forms a lump called a tubercule. Tuberculosis got its name from the Latin word tubercule, which means "little swelling." Tubercules have hard walls made of scar tissue. Inside the walls is a mixture of dead tuberculosis germs, live tuberculosis germs, and white blood cells. The tuberculosis germs are sealed in the tubercules like money locked in a safe. They are not destroyed, but they are isolated from the rest of the body. They can live sealed up like this for years.
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