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Tuberculosis

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Fabliha Ahad

on 7 May 2014

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Transcript of Tuberculosis

Tuberculosis

Tuberculosis is an infectious disease caused by a bacteria called Mycobacterium Tuberculosis.
TB usually infects the lungs. It can also infect other parts of the body, including the kidneys, spine, brain, bones and nervous system.


Two types of symptoms related to TB: Inactive TB and Active TB.
There are not many noticeable symptoms associated with inactive TB while active TB will give you noticeable symptoms.

long lasting cough with phlegm/ blood.
weight loss
night sweats
high temperature (fever)
tiredness and fatigue
loss of appetite

Symptoms
TB and HIV

People living with HIV are much more likely than others to get ill as HIV weakens their immune system. It also makes TB harder to diagnose and treat, resulting in untreated TB which speeds up the damage to a person’s health caused by the HIV virus. Those diagnosed with TB, should ask for an HIV test. It is possible to be treated for both infections at once and getting rid of TB will help your HIV medication work better.


Transmission
TB germs can be spread through sharing the same workplace with someone who has active TB. That infected individual is releasing the germs in the air by coughing, laughing, sneezing, singing, talking and even by playing any wind instruments (flute). The TB germs are known to stay in the air for hours. When a person is breathing in this air, the germs are brought into their lungs. Most people have a strong immune system and are able to fight the TB germs and stop them from taking hold. Unfortunately, some people have a weaker immune system that cannot fight the germs. These individuals now have the inactive TB infections. In some rare cases, TB can be transmitted from the mother to the baby at birth. However, TB germs cannot be spread through shaking hands or sharing food.

Who is at risk?
Anyone can get TB. You are at higher risk if you:
have lived, worked or traveled in countries where TB is common
have come into close contact with someone with TB (for example, family members or people sharing living spaces)
have HIV or AIDS
have a weak immune system (people who have had a serious disease or have had a transplant)
live in long-term residences (for example, seniors' homes)
live in crowded housing
live or have lived in a correctional facility (jail, prison)
are homeless
have already had active TB before
had TB in the past, but didn’t get proper treatment for it
live in communities with high rates of inactive TB infection or active TB disease


Treatment
It is very important for TB patients to get treatment right away. TB treatment can cure the patient and will stop them from spreading it to others. There are treatments for both the inactive and active TB germs.

With treatment, a TB infection can usually be cured. Most people will need a course of antibiotics, usually for six months. Several different antibiotics are used. This is because some forms of TB are resistant to certain antibiotics. If you are infected with a drug-resistant form of TB, treatment can last as long as 18 months. If you are in close contact with someone who has TB, tests may be carried out to see if you are also infected. These can include a chest X-ray, blood tests and a skin test called the Mantoux test.

Medicine
If you have inactive TB infection, there are TB germs in your body, but you do not have any symptoms. You need TB medicine to kill the germs and stop them from turning into active TB germs. Often times, a TB medicine called Isoniazid (INH) is prescribed. This medicine needs to be taken for 6 to 12 months. If taken as prescribed, it should cure the TB germs.
If you have the active TB disease, you will also be prescribed TB medicine. After you have taken the medicine for a few weeks, you will start to feel better and you will no longer be contagious. At this point, you can usually return to work, school and other activities. However, you will not be completely cured of TB, so you need to continue taking medicine.
A white blood cell phagocyte attacking Mycobacterium tuberculosis Bacteria
Discontinuation of the medicine can lead to a stronger TB germ, causing it to be harder to treat. If you develop a drug-resistant TB, you’ll need to take more medicine that are more expensive and have more side effects. The TB germs could then spread to other parts of your body and give you new symptoms.
BUT.....
Drug-resistant TB
Drug-resistant TB comes from very strong TB germ. When TB can resist the usual TB medicines, it's called drug-resistant TB. Sometimes TB resists the two most common TB medicines, isoniazid and rifampin. This is called multidrug-resistant TB or MDR-TB. Sometimes TB resists many common TB medicines: isoniazid, rifampin, fluoroquinolone, and at least one of three injectable medicines (capreomycin, kanamycin, and amikacin). This is called extensively drug-resistant TB or XDR-TB. Multidrug-resistant TB and extensively drug-resistant TB are very serious diseases. Since most the drugs typically used to treat TB is no longer effective, there must be new drugs produced in which the MDR and XDR TB cannot resist.
People with drug-resistant TB need to take medicines for longer than other TB patients, they may need to stay in the hospital for part of their treatment, in isolation and they need to take stronger medicine than other TB patients. The stronger medicines may not work as well as the usual TB medicine, they cause more side effects and are more expensive that the usual TB medicines. (Note that in Canada, most people get TB medicines for free). If you have drug-resistant TB disease, you can spread it to others and make them very sick. That's why you must get special medical treatment right away.
How common is TB?
Unfortunately, TB is a very common disease. More than 2 billion people (one third of the world’s population) are infected with TB. Ten percent of those people will become sick with active TB disease at some point in their lives. Every year, TB kills over 1.8 million people. In Canada, TB is not very common. In 2008, we had 1600 cases of TB. In Canada, TB is most common in aboriginal people, immigrants and refugees who were born in countries where TB is common.

Technological Treatments for TB
Peptides that are capable of creating holes in bacteria cell walls have been discovered. This alternative treatment can be used in order to treat MDR-TB. Three peptides have been designed and synthesized as anti microbial peptides (AMPs) known as molecular drill bits. These peptides are 10-50 amino acids long and are naturally produced by humans and other organisms.

The peptides must be positively charged and hydrophobic so they can easily disturb the bacterial membrane which is negatively charged with a lipid bilayer. These antimicrobial peptides can potentially be a new and powerfull class of antibiotics.
Tasnima Karim & Fabliha Ahad

http://www.thetruthabouttb.org/am-i-at-risk/health-immunityhttp://www.unitaid.eu/en/resources/press-centre/news/1273-2013-tuberculosis-medicines-technology-and-market-landscape

http://www.nhs.uk/conditions/tuberculosis/Pages/Introduction.aspx

http://homepages.rpi.edu/~felizd/tbproject/MolecularImplications.html

http://www.lung.ca/diseases-maladies/tuberculosis-tuberculose_e.php

http://www.cdc.gov/tb/publications/factsheets/general/tb.htm
Actinomycetes
Sources
Lungs affected by TB
How TB Attacks

The mycobacterium tuberculosis enter the macrophages of their host. Macrophages are white blood cells which are responsible in eliminating the bacterium such as TB. Tuberculosis makes the host sick by disrupting the normal functioning of the macrophages.


The digestive enzymes that macrophages use can no longer eliminate the bacterium. The bacterium which disrupts the immune system prevents the phagosome from proceeding into the acidic and hydrolytically active compartment, making it harder for the body to fight off diseases.

The bacterium invades the pulmonary alveoli and start multiplying. The infection usually spreads to the lymph nodes next, and then to the blood stream. When the bacteria enters the bloodstream, the fatality rate of tuberculosis drastically increases.

Tuberculosis is difficult to treat because the bacterium responsible is very good at avoiding the immunological responses which are used against it. The mycobacterium is able to position itself far away from antigen processing areas, making it difficult for the immune system to develop an antigen for the infectious bacteria. Although, the host cell can reduce the pH in the cell's vacuole, which reduces the growth of the bacterium. Tuberculosis can also be treated by Actinomycetes a group of fungi which is characterized by a branching and chaining pattern of growth.
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