TUBERCULOSIS

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TUBERCULOSIS

• By Creston Brown and Lindsay Saelinger

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WHAT IS IT?

• Bacterial infection
• Caused by Mycobacterium tuberculosis (also called
  tubercle bacillus)
• Damages a persons lungs or other parts of the
  body
• Fatal if not treated properly

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TRANSMISSION

• Spreads through the air when a person with active
  TB
• Coughs
• Speaks
• Laughs
• Sneezes
• Sings
• Another person breathes in the bacteria and
  becomes infected

http//www.cpmc.columbia.edu/resources/tbcpp/about
tb.html.
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INSIDE THE BODY

• Breath in infected air and bacilli go to lungs
  through bronchioles
• Bacilli infect alveoli
• Macrophages attack bacteria, but some survive
• Infected macrophages separate and form tubercles
• Dead cells form granulomas

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ACTIVE vs. LATENT INFECTION

• Unhealthy person
• Bacilli overwhelm immune system
• Bacilli break out of tubercles in alveoli and
  spread through bloodstream
• This is active TB
• Healthy person
• Initial infection controlled by immune system
• Bacilli remain confined in tubercles for years
• This is latent TB

http//www.cpmc.columbia.edu/resources/tbcpp/about
tb.html.
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SYMPTOMS

• Perpetual Cough
• Fever
• Weight loss
• Night sweats
• Loss of appetite
• Fatigue
• Swollen glands
• Chills
• Pain while breathing

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DIAGNOSIS

• Skin test- Mantoux test
• PPD injected in forearm and examined 2-3 days
  later
• Red welt around injection indicates infection
• Examine medical history, x-rays, and sputum

http//www.arches.uga.edu/efletch/TBtx.htm
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MOST SUSCEPTIBLE

• People at higher risk of TB infection
• Close contacts with people with infectious TB
• People born in areas where TB is common
• People with poor access to health care
• People who inject illicit drugs
• People who live or work in residential facilities
• Health care professionals
• The elderly

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MOST SUSCEPTIBLE (CONT.)

• People at higher risk of active TB disease
• People with weak immune systems (especially those
  with HIV or AIDS)
• People with diabetes or silicosis
• People infected within the last 2 years
• People with chest x-rays that show previous TB
  disease
• Illicit drug and alcohol abusers

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TREATMENTS

• Take antibiotics for 6-12 months
• Preventative drug to destroy dormant bacteria
• For active TB, 4 medications isoniazid,
  rifampin, ethambutol, and pyrazinamide
• Vaccines (relatively ineffective today)

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BIOLOGICAL EFFECTS ON HUMANS

• Causes more deaths than any other infectious
  disease
• About 2 billion people infected worldwide
• Major health problem in developing countries
• Leading killer of youth and young adults
• Leading cause of death for women of childbearing
  age

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Tuberculosis

• First Sighting (2400 BCE) Egyptian Mummies
• Fragments of spinal column
• 460 BCE Hippocrates Identification
• Says most widespread disease of time
• Always fatal
• Warning to doctors do not visit patient

http//www.umdnj.edu/ntbcweb/history.htm.l
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Tuberculosis

• Exact Descriptions (1679) Sylvius Opera Medica
• First to describe impact on lungs
• Italian Medical Literature
• First reference to infectious nature of TB in
  Italian Medical Books
• Edict by Republic of Lucca

http//www.goshen.edu/bio/Biol206labproject/tricia
/tbhx.html.
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Tuberculosis

• 1720 Dr. Benjamin Martin
• A New Theory of Consumption
• TB is easy to Catch!
• First Major Step Against TB Sanatorium
• Hermann Brehmer Silesian botany student
• Doctor Go to healthier climate
• Trip to Himalayan mountains Cured!!!!!!!!!!

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Tuberculosis

• Sanatorium (Continued)
• Brehmer presented doctoral dissertation
• It was called, TB is a Curable Disease
• Created Sanatorium
• Thousands in US and Europe
• Ironic Solution
• Movies Drug Lords, crime

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Tuberculosis

• Jean-Antoine Villemin (1865)
• French military doctor
• Humans-Cattle-Rabbits
• Microorganism cause of disease
• TB DOES NOT arise spontaneously

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Tuberculosis

• Robert Koch (1882)
• Able to see TB!
• Excitement that we can beat TB!

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Tuberculosis

• Forlanini First use of surgical methods
• Collapsing of lung
• Reduce lung volume
• Calmette and Guerin
• Basis for BCG vaccine

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Tuberculosis

• Breakthrough
• November 20th, 1944
• Antibiotic first administered
• Effects immediate
• Bacteria disappeared from sputum
• Rapid Recovery

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Tuberculosis

• TB Today
• Correlates with Economy
• Africa, Asia, Latin America
• 8 Million contract tb
• 2-3 million die
• Multi-drug resistance

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Tuberculosis

• Multi-drug resistance
• Four drug regiment
• Create stronger medicines

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Tuberculosis

• Adaptive aspect
• Acquired Cell Immunity
• Ability to initiate th1
• Dendritic Cells
• Ability to active more th1 cells

• www.jimmunol.org/cgi/content/full/172/5/2748.

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SOURCES

• A Brief History of Tuberculosis. 6 March 2005
  http//www.umdnj.edu/ntbcweb/history.htm.
• Bhatt, Kamlesh. Cutting Edge A New Approach to
  Modeling Early Lung Immunity in Murine
  Tuberculosis. The Journal of Immunology 172
  (2004). 10 March 2005 www.jimmunol.org/cgi/content
  /full/172/5/2748.
• Brief History of Tuberculosis. National
  Tuberculosis Center. 10 March 2005
  http//www.umdnj.edu/ntbcweb/history.htm.
• History of Tuberculosis. New Jersey Medical
  School National Tuberculosis Center. 10 March
  2005 http//www.goshen.edu/bio/Biol206labproject/t
  ricia/tbhx.html.
• Questions and Answers About TB. CDC. 6 March
  2005 http//www.cdc.gov/nchstp/tb/faqs/qa_introduc
  tion.htm.
• Tripathi, Rama P. Fighting Tuberculosis An Old
  Disease With New Challenges. Medicinal Research
  Reviews 25.1 (2004) 6 March 2005
• Tuberculosis. 6 March 2005 http//www.arches.uga
  .edu/efletch/symptoms.htm.
• Watson, Debra. The Worst Year In History For
  Tuberculosis. World Socialist Website.
  International Committee of the Fourth
  International. 6 March 2005 http//www.wsws.org/sc
  ience/1998/jun1998/tb-j20.shtml.
• What You Need To Know About Tuberculosis. 6
  March 2005 http//www.cpmc.columbia.edu/resources/
  tbcpp/abouttb.html.
• Zar, Heather J. Tuberculosis in the Developing
  World. Pediatric Pulmonology 26 (2004) 6 March
  2005