"The question is whether the germ is resistant to antibiotics" | TIME ONLINE

Tuberculosis broke out in a school in Baden-Wuerttemberg. Four students are sick, at least 109 people have already been infected with the disease. In Germany, the disease can be treated easily, but still dies about 100 people each year in this country. The infection can be dangerous and why a vaccine is not recommended in Germany, says immunologist Stefan Kaufmann.

ONLINE TIME: Mr Kaufmann, cases of tuberculosis in Germany are rare. Now, many people are affected at once. Are you surprised?

Stefan Kaufmann: Yes and no More than 100 infections at once, that is a very high number. At the same time, I'm not surprised that tuberculosis still occurs in Germany. According to the Robert Koch Institute, there were about 5,500 cases last year. Around the world, the disease is still a big problem. No pathogen kills more people.

Stefan Kaufmann, director of the Max Planck Institute for Infectious Biology in Berlin
© David Ausserhofer / MPIIB

ONLINE TIME: How is the disease spread?

traderTuberculosis is relatively easy to transmit by droplet infection. When a person with the disease coughs, the virus spreads in the air. Anyone nearby can collect germs by inhaling. They enter the lungs and install in the alveoli. There, they are eaten by the body's own cells and begin to multiply exponentially. The immune system tries to destroy the pathogen. This is a particularly robust Mycobacterium. Instead of destroying them, the immune system usually suppresses pathogens. They are then controlled, so to speak, so as to avoid any symptoms such as night sweats, loss of appetite, weight loss and especially coughing.

ONLINE TIME: In other words, can a person transmit the disease only if it has appeared on its own?

Kaufmann: Yes. As a rule, individual infections remain undetected for a long time. A few months and sometimes years later, it is only the appearance of the disease. This suddenly infected more than one hundred people, is rather unusual. In the case of Bad Schönborn, a person had to bring the disease to school and trigger the avalanche. Maybe someone who has changed class frequently. This would explain the high number of infections. It is also possible that two people brought the pathogen.

ONLINE TIME: What is happening now to people who have had the symptoms?

Kaufmann: First, they are isolated and must not enter the school or other public places. How strictly is this treated, for example if a child can still see his parents, for example, the doctor has to decide individually. The treatment then takes several months. He gave different drugs. The key question is whether the germ is against the strong antibiotics resistant or not. If he starts taking medication, one can go out after a few months of complete healing. Especially if the disease is detected early, the lung lesions are so weak that they do not play a clinical role.

ONLINE TIME: How exactly do mycobacteria of tuberculosis affect the lungs?

Kaufmann: If the immune system eliminates the pathogen present in the lungs, it is a protective effect initially. However, as the immune system weakens, the response of the pathogen and bunker spreads. It creates visible shadows on the radiographic image of patients. In these areas, pulmonary functions are then very limited.

ONLINE TIME: Does this mean that the disease starts when the immune system is weak?

Kaufmann: Exactly. This is why TB is the leading cause of death among people living with HIV in Africa. Because HIV damages the immune system. Even the elderly are particularly at risk. And infants under five whose immune system is not yet fully developed.