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Peyton Evans

on 21 February 2015

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Transcript of Tuberculosis

Tuberculosis is an ancient disease that has been around for 15,000 to 20,000 years
M. tuberculosis
has been found in artifacts from ancient Egypt, India, and China
Traces of
M. tuberculosis
have been discovered in the lungs of Egyptian mummies from approximately 1,000 BC
In the Middle Ages, TB of the cervical lymph nodes and scrofula (neck lymph nodes) was dubbed the "king's evil"
The populace widely believed that the "king's evil" could be cured when the kings simply touched those who were infected
TB was commonly called "consumption" until well into the 20th century because of the fragile, wasted-away appearance of TB victims
Transformation of Treatments
Heinrich Hermann Robert Koch, a German bacteriologist, first identified TB in 1882
Prior to the discovery of any medical treatments for tuberculosis, the only option was to isolate patients in sanatoriums- hospitals only for those with tuberculosis
Patients were wheeled outside to be given lots of fresh air to cleanse out their lungs
To allow for minimal exertion of the lungs, patients were kept in their beds all day
Tuberculosis vaccines were developed during World War I and were first used in 1921
Streptomycin, the first antibiotic effective against
M. tuberculosis
, was discovered in the early 1940's
As patients neglected to complete their antibiotic treatments, multidrug-resistant strains began to thrive
As of 1992, over 33% of TB strains were resistant to one drug, and nearly 20% were resistant to two drugs
Although advancements in antibiotic treatments have been made, these drug resistances have made it difficult to find the proper cures
Prevalence Throughout History
The industrial revolution in the 1800s saw an increase in TB cases in Europe
As people moved to towns with unsanitary, crowded living conditions, it was easier for tuberculosis to spread
In 1815, tuberculosis caused a fourth of all deaths in England
In the early 1900s, tuberculosis was the leading cause of death
Over 80% of Americans were infected with TB before age 20
In 1918, TB caused a sixth of all deaths in France
The US was home to more than 700 TB sanatoriums by 1938
In the mid-1980's, the number of tuberculosis cases in America increased again because of the overcrowded, unsanitary conditions of the destitute areas of large cities
Infected visitors and immigrants arriving in the US also contributed to the situation
Historic Beginnings
Susceptibility and Prevalence
About 60% of TB cases in the US are in ages 25-65
Children and the elderly have an increased risk of contracting TB
About 1/4 of newly diagnosed TB cases occur in those aged 65+; many had latent TB when they were younger, but as they aged their immune systems could no longer control it, so they developed active TB
Those with HIV/AIDS have also have an increased risk
TB is actually the leading cause of death for those with HIV, causing nearly 1 in 4 deaths
TB is especially prevalent in developing nations where modern health care is a challenge
Usually affects people who drink, do drugs, and have mental issues
Also affects those that are homeless or suffer from other illnesses
Signs and Symptoms
Symptoms in Pulmonary Tuberculosis, which affects the lungs:
Coughing, especially coughing up yellow or green mucus that may be streaked with blood
Low-grade fevers
Loss of interest in food and loss of weight
Chest pains
Difficulty breathing
Symptoms in Extrapulmonary Tuberculosis, which affects other organs and tissues:
In bones- collapsed vertebrae and paralysis in legs
In abdominal cavity- pain ranging from the minimal discomfort of stomach cramps to the intense pain of appendicitis
In joints- arthritis in hips and knees and inflammation and pain in wrists, hands, and elbows
In meninges- TB meningitis, which is characterized by headaches, drowsiness, and comas, causes permanent brain damage and tuberculoma, which causes stroke-like symptoms
In skin, intestines, adrenal glands, and blood vessels- ruptured aorta and TB pericarditis, in which the membrane around the heart is filled up with a fluid that interferes with the heart's ability to pump blood
Miliary TB- marked weakness and weight loss, gradual wasting of the body, and severe anemia
Acquisition and Diagnosis
The bacteria
M. tuberculosis
is released into the air and spread by droplet infection
The tubercle bacilli are released when an infected individual exhales, sneezes, or coughs
A person in close physical contact breathes in this mist
As TB is not highly contagious, close, frequent, or prolonged contact is required for it to spread
Once infected:
The immune system can kill the bacteria
The bacteria can become dormant, causing what is known as latent TB
The bacteria multiplies immediately, causing active, contagious tuberculosis
Presence of
M. tuberculosis
is tested by performing a skin test; the skin of an infected person becomes red, hard, and swollen in 1-3 days
Test results are verified with a chest X-ray and a biopsy
Molecular tests have become increasingly more common in recent years
What YOU can do
One of the best ways to get involved and make a difference is to donate to the organizations to help them continue their work, spreading the word about TB in the process
You can also create a trust or foundation to contribute money to the cause or spearhead a charity event
As a responsible citizen, stay well informed on tuberculosis developments and encourage others do so as well
Urge legislature to be proactive on the development of new drugs
Make sure that you follow through with tuberculosis testing as required for jobs and college
TB Alert
Works with both advocacy and treatments
Recognizes that just getting people to accept treatment is often one of the biggest hurdles
International policy is a priority, focusing on care, prevention, and controlling the spread of TB
The World Health Organization
WHO "aims to advance universal access to TB prevention, care and control, guide the global response to threats, and promote innovation"
Action: Global Health Advocacy Partnership
Partnership of organizations around the world "working to influence policy and mobilize resources to fight diseases of poverty and improve equitable access to health services"
TAG- Treatment Action Group
TAG is "a group of activists, clinicians, researchers, implementers, foundation and government officials, and policy makers..." who focus on "...the world's struggle against tuberculosis..." to achieve "...zero TB deaths, zero new TB infections, and zero suffering from TB"
Bill and Melinda Gates Foundation
Focuses on "...improved vaccines, more effective drug regimes, new diagnostic tools, disseminating innovations in TB control, access, efficiency and cost reductions, and advocacy"
History of TB
Infection, and Symptoms
Worldwide Help
Recovery in a
What IS
An Infectious Lung Disease
A Global Epidemic
The Notorious M. tuberculosis
Early 1950s
High fever, knew lungs were affected
Diagnosed through x-ray and sputum test
Pseudo-quarantine and complete rest recommended
Applied to Denver Sanatorium
1 3/4 year stay
Living Conditions
Room: single bed with narrow path for nurse
One door to hallway, one door to porch
Usually confined to bed for complete rest and no exertion
Bed pushed outside daily for fresh air
All meals in bed
No listening to radio allowed - too stressful on the patients
Visitors allowed
Chapel and organ concerts once a week
Medical Situation
Complete rest, bed bound
Low rate of recovery for patients with rest only treatment
Experimental drugs introduced early into her stay
Up to 40 pills daily along with weekly injection
Periodic x-rays
Tuberculosis, or TB, is a chronic and potentially fatal, yet treatable, contagious disease that primarily affects the lungs, but can also affect other parts of the body
The word "Tuberculosis" is derived from the Latin word "tuberculum", which means small swelling, bump, or protuberance
Tuberculosis has also been called The White Plague and Consumption
The bacteria
M. tuberculosis
causes tubercles, which are small, round swellings, to form on mucous membranes
TB is the second most fatal disease in the world, and it is linked to the worldwide HIV/AIDS epidemic
Tuberculosis has been declared a global epidemic and is the second most fatal disease in the world
The link between HIV/AIDS and TB is considered a co-epidemic, and more HIV victims die of TB than any other disease
About 30% of the world's population is infected with the bacteria
M. tuberculosis
Out of the 23,000 people that fall ill with tuberculosis daily, over 3,500 of them die
Tuberculosis is most rampant in developing countries that lack modern health care, including Bangladesh, India, Malawi, Zambia, and Zimbabwe
More developed countries such as China, Russia, and South Africa are also at high risk
Many strains of TB are also becoming resistant to antibiotics, creating multidrug-resistant strains
These strains are even harder, riskier, and more expensive to treat
The World Health Organization (WHO) estimates that a complete cure for TB in the developing world could cost only $13, but a treatment for a multidrug-resistant strain of TB in New York City could cost up to $180,000
WHO predicts that about $100 million needs to be spent annually to provide a modern infrastructure, medicines, and microscopes for developing nations to create effective TB programs
Although various strains of mycobacteria cause tuberculosis, by far the most common is
Mycobacterium tuberculosis
WHO estimates that about a third of the world’s population is infected with
M. tuberculosis
, and 5-10% of them will develop active tuberculosis
The rest of the infected people who do not develop symptoms have latent tuberculosis
TB has a misunderstood stigma attached to it, because you can fully recover from tuberculosis, unlike HIV
People are unreasonably afraid to be in proximity with cured TB patients because they erroneously believe that they are still a risk
Despite popular belief, you cannot contract tuberculosis by kissing, engaging in bodily contact, sharing food or drink items, or touching objects
By Carissa Petzold and Peyton Evans
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