The Union Health Ministry on Saturday has reiterated its recommendations on Tuberculosis (TB) screening for all Covid-19 positive patients and vice versa amid reports of a surge in TB cases amid the pandemic.
The ministry issued the advisory after reports of rising cases of Tuberculosis among patients who were infected with Covid-19. “It is clarified that Tuberculosis (TB) screening for all COVID-19 positive patients and COVID-19 screening for all diagnosed TB patients has been recommended by Ministry of Health and Family Welfare (MoHFW). States/UTs have been asked for convergence in efforts for better surveillance and case finding of TB and COVID-19, as early as August 2020," the official statement read.
Moreover, the government issued multiple advisories and guidance to reiterate the need for bi-directional screening of TB-COVID and TB-ILI/SARI in states and union territories.
The advisory comes as case notification for tuberculosis decreased by about 25% in 2020 due to Covid-19 related restrictions. The Centre said special efforts are being made to mitigate this impact through intensified case finding in OPD settings as well as through active case finding campaigns in the community by all states.
However, the government clarified that there is not enough evidence to suggest that there has been an increase in TB cases due to Covid-19.
Highlighting the dual morbidity of Tuberculosis (TB) and Covid-19, the health ministry said both the diseases are known to be infectious and primarily attack the lungs, presenting similar symptoms of cough, fever and difficulty in breathing. However, TB has a longer incubation period and a slower onset of disease, it said.
In a warning against post covid diseases such as black fungus, the ministry said SARS-CoV-2 infection could make an individual more susceptible to developing active TB disease, as TB is an opportunistic infection like black fungus.
Drawing parallels between decreased immunity in both tuberculosis and Covid-19 patients, the ministry said TB bacilli can be present in humans in a dormant state and has the potential to start multiplying when the individual’s immunity is compromised for any reason. The same is applicable in the post-Covid scenario, when an individual may develop decreased immunity due the virus itself or due to the treatment, especially immune-suppressants like steroids.