In 2021, Romania recorded hundreds of deaths in children under 15 years old, caused by respiratory diseases. According to Eurostat data, we are talking about the highest number of deaths recorded in EU countries in this age group. And in the age category under one year, the situation is even worse if we make a comparison with the other countries. Basically, we are talking about 51.4% of the total number registered at the level of the European Union.
Most often, children get the TB germ from the family. Source: archive
According to INS data, 18% of Romanian children lose their lives due to a respiratory disease. This condition ranks third after perinatal conditions and traumatic injuries. The respiratory diseases that cause the greatest mortality are asthma and tuberculosis. Four years ago, more than 5,000 children were diagnosed with asthma, most cases occurring in the 0-4 age group. Tuberculosis, however, is even more worrying, say specialists in the field, who sound a big alarm. In 2022, 325 cases of illness were registered in Romania, an increase compared to 2021, when we had 281 cases of illness.
“During the covid pandemicthe global incidence of tuberculosis in us has decreased, but it was something artificial. Because, in reality, things happened differently”, Dr. Adriana Sorete-Arbore, a doctor specializing in lung diseases at the Iași Pneumophthisiology hospital, explained to “Adevărul”.
“During the imposed restrictions, people stopped going to the doctor, didn’t get their tests done, didn’t come for follow-up anymore. The isolation, the lack of communication, the fear of exposing yourself to the hospital environment made the number of reported cases of TB disease lower. As an idea, during that period, between the years 2020-2021, we had somewhere around 43 cases per hundred thousand inhabitants, in the idea that before the pandemic we had around 60 cases per hundred thousand inhabitants. Immediately after the pandemic, the number of illnesses started to increase again”the specialist also said.
Children, victims of ignorant or overprotective parents
The doctor wanted to specify an aspect that not everyone knows: in general, children get sick from tuberculosis taken from adults with whom they come into contact: “They have a source of microbes in their immediate environment: mother, father, grandparents. Logically, if we have more sick adults, then we will also have children”.
But beware! We must distinguish between a sick patient and an infected one, warns the doctor. “Infections do not mean that they are sick with tuberculosis. It means that they have received the microbe in their body, that they are carriers and must be treated prophylactically. While prophylactic treatment involves the administration of a single drug, sick patients with symptoms are treated with four different drugs.”
In such a situation, when we are dealing with an infected child, doctors are often faced with parents’ refusal to treat their child preventively. “Some go too far in denial, refusing chemoprophylaxis when it is recommended. On the grounds that they know better, the child has nothing, it does not need to be treated. On the other hand, there are also hyperprotective parents who, in order to discover whether their children are infected or not, torment them with additional, invasive and unnecessary investigations. When he could give them the prophylactic treatment and it would solve the whole problem. But they don’t want to because they say the drug is hepatotoxic. But adverse effects are very rare. It’s like in that story with the grain of salt”.
How you can get tuberculosis. Doctor: “It’s not that simple”
Unlike flu, respiratory viruses, childhood diseases, etc., we cannot get sick from tuberculosis with one or two, even if the disease is airborne. “What we need to know is that you don’t get tuberculosis if you’re on public transport and someone coughs in your face. Or if you use the personal belongings of a sick person. In order to get sick, you have to stay near a sick person for at least three months, at a distance of one meter, one and a half meters and for four hours a day. The contact, therefore, must be relatively close and of longer duration. The most exposed are those in the sick person’s family, students in a classroom if they have a sick teacher or people who work in collectives”, the specialist also specified.
What symptoms should send you to the doctor
The disease has symptoms that do not alarm in the first instance. “It begins insidiously, with a malaise, with a state of lassitude, with the lack or loss of appetite, with weight loss. Among the symptoms are a dry, irritating, persistent and excruciating cough which, over the course of two to three months, turns into a productive cough. Expectorations are yellow, greenish, grayish yellow or even bloody. The patient sweats a lot and has a low fever.” The disease, if not treated, leads to death. “Adults lose their lives in greater numbers than children”said Dr. Adriana Sorete-Arbore.
Why do we go to the doctor at the last moment, when the disease is much worse? “Because we don’t have basic health education, because we don’t value our health and life. Out of ignorance, ignorance. Adults think it’s a joke. They know how to explain all their symptoms with trivial things. I cough because I smoke, I’m tired because I get out of bed in the morning, because I have to get to work, I sweat because it’s hot in the house, I don’t eat during the day because I don’t have time. When I get home in the evening I don’t eat because I’m tired and I don’t have any appetite. These justifications and this postponement of seeing a doctor make the tuberculosis progress. The disease progresses slowly, in a year, a year and a half. It depends on the land on which the tuberculosis microbe settles.”
Many times, when they reach the doctor, these patients are in serious condition, with very damaged lungs. “The germ makes holes in the lung. When the microbe gnaws at it, the lung becomes perforated, the patient can no longer breathe, can no longer exert physical effort, some of those holes can even burst and then there is a risk of air entering the rib cage. It’s called pneumothorax, it’s a painful condition and it’s treated surgically.”
Vaccination is done only at birth
The tuberculosis vaccine is given at birth. It is part of the mandatory vaccination scheme. But, the doctor states, this does not mean that an immunized child will not be infected and will not fall ill with TB. Because the risk exists. “This vaccine protects the child during the first three years of life, while his immune system is developing. Then, after the age of three, the child will come into contact with the microbe naturally. Join the community at the nursery, kindergarten, school. Vaccination and contact with the microbe lead to the body’s natural immunization. Obviously, we are talking about a healthy child with a normal immune system. In the case of a deficient immune system, the child risks illness. That is, he comes into contact with a sick person, takes the microbe and instead of remaining only a carrier, he gets sick, the organism succumbs”.
How we prevent diseases
Therefore, we cannot protect ourselves from this disease as we can protect ourselves from, for example, the flu or a cold. We are vaccinated only once, at birth. And then everything depends on our body. “If we are around a sick person, we must follow prophylactic treatment. If the specialist recommends it. Then, we should keep our immune system healthy and strong so that it can fight infection. Let’s take care of our lifestyle: don’t smoke, don’t drink alcohol, go to the doctor regularly for routine tests. The disease often appears against the background of lack of education, poverty against the background of a certain socio-economic situation. There are people who don’t have a family doctor, who haven’t been to the doctor for years, who don’t have medical insurance”, said Dr. Adriana Sorete-Arbore.
