Tuberculosis

Tuberculosis (TB) is a common and deadly infectious disease caused by various mycobacteria, mainly Mycobacterium tuberculosis.

Tuberculosis (TB) is also or formerly known as Consumption, Gibbus of the Spine and Joints, King’s Evil, Lupus Vulgaris, Phthisis (Greek for consumption), Phthisis Pulmonalis, Pott’s Disease, Scrofula, Tabes Mesenterica, TB of the Abdomen, TB of the Skin, Wasting Disease, and White Plague.

Tuberculosis was called:

      -Consumption because it seemed to consume people from within.

 

      -White Plague because sufferers appear markedly pale.

 

    -King’s Evil because it was believed that a king’s touch would heal the disease.

Tuberculosis most commonly attacks the lungs, but it can also affect the central nervous system, the lymphatic system, the circulatory system, and the genitourinary system, as well as the bones, joints and even the skin.

Military Tuberculosis, also known as Disseminated TB, occurs when the Tuberculosis invades the circulatory system resulting in internal lesions which have the appearance of millet seeds on X-ray. More than one-third of the world’s population have been exposed to the TB bacterium, and one new infection occurs every second somewhere in the world.

Not everyone who is infected with the TB bacteria develops the full-blown disease. Indeed, most people do not show any symptoms at all and the disease is latent inside them. Approximately one in ten latent infections progress to become active Tuberculosis.

Deaths from Tuberculosis most commonly occur in developing countries. Approximately 1.5 million people die worldwide from Tuberculosis each year.

However, an increasing number of people in the developed world are contracting Tuberculosis because their immune systems have been adversely affected due to their use of immunosuppressive drugs, illegal drugs, substance abuse, and/or infection by HIV/AIDS.

In addition, drug-resistant strains of the TB bacteria are on the increase, and are causing a rise in the number of Tuberculosis cases, even in the developed world.

As a result of these factors, doctors around the world are anticipating a frightening resurgence in Tuberculosis.

Tuberculosis is an ancient disease, that has been around at least as long as 4000 BC. This is known because Tb bacteria have been found in human remains dating from this period.

Tuberculosis Symptoms

The symptoms of Tuberculosis include:

– Appetite loss
– Bloody cough (coughing up blood)
– Chest pain
– Chills / Shivering
– Easily fatigued
Fever
Night sweats
– Pallor (very pale skin)
– Restlessness
– Swollen neck glands (because of the diseases affect on the lymphatic system)
– Wasting away of the body
– Weakness
– Weight loss

Approximately 10% of people infected with Tuberculosis go on to develop active, full-blown Tuberculosis which kills more than half of its victims if left untreated.

Causes

Tuberculosis (TB) is a common and deadly infectious disease is mainly caused by the Mycobacterium tuberculosis bacteria. However, other bacteria, such as Mycobacterium bovis, Mycobacterium africanum, Mycobacterium canetti, and Mycobacterium microti, can also cause Tuberculosis but this does not normally occur in healthy adult humans.

Transmission

Transmission can only occur from people who have active rather than latent – Tuberculosis (TB).

When people suffering from Active TB cough, sneeze, speak, or spit, they expel tiny infectious droplets into the air. For example, a single sneeze or cough can release thousands of tiny droplets, any of which can be breathed in by another person and potentially cause them to become infected.

People with prolonged, frequent, or intense contact with Active TB sufferers are at highest risk of becoming themselves infected with TB. The chances of transmission between people depends upon the number of infectious droplets expelled by the Active TB sufferer, the amount of ventilation in the location, the duration of exposure, and the virulence of particular bacterial strain that is causing the TB. After two weeks of anti-Tuberculosis therapy, Active TB sufferers stop being contagious, providing the TB bacteria are not resistant to the medications being used.

Tuberculosis can be carried by mammals. Domesticated animals, such as cats and dogs, are generally free of Tuberculosis, but some domestic animals, such as cows, and wild animals may be carriers of the disease.

Treatment

The treatment for Tuberculosis involves the use of antibiotics to kill the bacteria that are causing the infection.

The most common antibiotics used are:

  • Isoniazid
  • Pyrazinamide
  • Rifampicin
  • Rifampicin and Isoniazid are the two most effective front-line medications for the treatment of Tuberculosis.

Warning:
– Rifampicin should not be used in conjunction with Pyrazinamide, because there is a risk of hospitalization and death from liver damage when these medications are combined.

A long course of antibiotics (usually 6 to 12 months) is required to completely eradicate Tuberculosis bacteria from the body.

Latent Tuberculosis is usually treated with a single antibiotic, while Active Tuberculosis is treated with multiple antibiotics at the same time to reduce the chances of the bacteria developing antibiotic resistance.

People infected with Latent Tuberculosis should seek treatment to prevent them from developing Active Tuberculosis later in life

Tuberculosis bacteria develop resistance to drugs and medications that are used during TB therapy because of:

      – Inadequate treatment,
      – Sufferers not taking the prescribed medications properly or for the full term of the treatment,
              – The use of low quality medications, which do not work as effectively as quality medications

Drug-resistant TB is an increasingly serious public health issue, especially in developing countries, because treatment times are longer and newer, more expensive drugs are required.

Multi-Drug Resistant Tuberculosis (MDR-TB) occurs when the TB bacteria are resistant to the two most effective first line TB medications: Rifampicin and Isoniazid.

Extensively Drug-Resistant Tuberculosis (XDR-TB) occurs when the TB bacteria are also resistant to three or more of the six classes of second-line TB medications.

After two weeks of anti-Tuberculosis therapy, Active TB sufferers stop being contagious, providing the TB bacteria are not resistant to the medications being used. However, the full course of antibiotics (over 6 to 12 months) must be completed to provide the most effective treatment and reduce the chances that some of the TB bacteria will become drug resistant and survive.

Prevention and Control

The following techniques are used to attempt to prevent and control Tuberculosis:

– Treatment: people with Tuberculosis and their contacts are identified and then treated with a full course of the appropriate antibiotic medications. Identification of TB infections involves testing high-risk groups for TB bacteria.

– Vaccination of Children: children can be are vaccinated with the BCG vaccine to protect them from Tuberculosis, including serious forms of TB, such as Meningitis. At the current time, no reliable vaccine is available to protect adults.

Further research is constantly being conducted into other treatment options for Tuberculosis, including new drugs and medications, vaccines, and so on. For example, research is continuing into Recombinant Tuberculosis Vaccine, DNA TB Vaccine, and combining vaccines with conventional chemotherapy medications, and a range of other treatment and vaccination options.

Image: woodleywonderworks/Flickr

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