Tuberculosis

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Tuberculosis

• Human Disease Project
• By Alex L
• December 20, 2006

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What is Tuberculosis

• Called TB for short
• Infectious disease that usually attacks the lungs
  but can also attack any other part of the body
• Each year approximately 9 million people become
  ill with the disease, and 2 million of those die
• Tuberculosis is caused by the bacteria
  Mycobacterium tuberculosis
• divides about every 16 to 20 hours
• Can withstand weak disinfectants
• Rod-shaped form
• Spreads by air from person to person
• Comes in two stages
• Latent TB bacteria is dormant, not contagious
• Active TB about 10 of the people with latent TB
  becomes this. very contagious

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History of TB

• Present since ancient times
• Earliest found proof in 4000 B.C. skeleton
• Thought to have come from cattle when humans
  domesticated livestock
• During the 18th and 19th century, TB was
  prevalent in London and all of Europe.
• In 1882, Dr. Robert Koch discovered the cause of
  TB

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Who Gets TB

• Anyone can get TB. However, those whose immune
  system is weakened are prone to get tuberculosis,
  for example, people who
• live in poor environments
• have AIDS
• live with a tuberculosis victim
• are old
• are newborns
• have diabetes
• have kidney disease

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Symptoms of TB

• Person with latent TB has no symptoms
• Person with active TB will have none, some, or
  all of these
• chest pain
• severe coughing (some times with blood)
• appetite loss
• weight loss
• fever
• night sweats
• chills

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How TB Affects the Body

• Once mycobacterium tuberculosis enters the lungs
• If the immune system is strong, then it will lay
  dormant latent TB
• If the immune system is weak, then the bacteria
  attack the lungs, slowly disintegrating it
  active TB
• When damaged, the lungs expel pus.
• This coughed up pus, often mixed with blood, is
  called sputum

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How a Persons Daily Life Affected

• If a person has latent TB, then they must take
  medication every day for 6 months. Even after
  this, there is still a small chance of getting
  active TB
• If a person gets active TB, then they must take
  medication immediately for 9 months.

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Diagnose of TB

• Tuberculin skin test
• Chest X-ray
• Physical examination
• Serological (blood) test
• AFD test (collect sputum to smear and culture it)

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Treatment for active TB

• A combination of the following four antibiotics
  are the most commonly used, however are not risk
  free
• rifampicin
• It may cause fever, rashes, liver damage, and in
  some rare cases has led to death.
• isoniazid
• It may cause rash and abnormal liver function
  tests.
• ethambutol
• It may cause Red-green color blindness and loss
  of vision
• pyrazinamide
• It may cause joint pains, nausea, vomiting, skin
  rash,, malaise, and fever
• When taking antibiotics, overdose and underdose
  is a problem

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Drug Resistant TB

• Very dangerous form of TB
• becomes resistant to drugs when they are
  improperly used against it (under dose of
  medication).
• drug resistant TB can be spread to others, just
  like regular TB.
• it is important that patients with TB disease
  follow their doctor's instructions for taking
  their TB medicine so that they will not develop
  drug resistant TB.
• Multi-drug-resistant TB (MDR-TB)
• resistant to at least 2 drugs
• Extensive-drug-resistant TB (XDR-TB)
• resistant to 5 or more drugs

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Current Research/Challenge

• US CDC (Center for Disease Control and
  Prevention) is working to prevent further drug
  resistant TB spreading
• improve TB control on the borders
• improve tests to diagnose the TB
• insure completion of TB treatment
• WHO (World Health Organization) also has many
  plans to stop and prevent TB
• contribute to health system strengthening
• address TB/HIV, MDR-TB, XDR-TB, and other
  challenges
• The death tolls are increasing by 1 each year
  due to the increase of death in Africa most are
  because of XDR-TB , MDR-TB, and TB/HIV
• intense control efforts in Africa are trying to
  make the incidence fall

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Death Tolls in South Africa
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Interview with Dr. Jean Wong, an Internal
Medicine doctor on 12/16/06 and 12/18/06 via
E-Mail

• Q Have you ever seen a TB victim? If yes, what
  characteristics do they have? How many cases do
  you see a year? 
• A I see about 2 cases a year. The patients are
  usually immigrants. Tb can involve different
  organs, the most common one is lung. Typical
  patient comes in with cough, sometimes coughing
  up blood, fever and night sweats, sometimes
  weight loss. But recently I had a case of
  abdominal TB, patient came in with fever and abd
  pain. It was quite challenge to make the right
  diagnosis. p.s all the cases have to report to
  county disease control. the county will do a case
  study to make sure to check everybody exposed.

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Interview (Continued)

• Q How does a person get TB?
• A people get TB from close contact with TB
  patient. usually from coughing. But once somebody
  infected with TB, he may not get sick right away.
  He may just carry TB, and TB may get activated
  late on.
• Q How is TB detected?
• A to definitely detect or diagnose a person
  with TB. doctor needs to collect sputum  to smear
  and culture it. it is called AFB testing.  if the
  sputum is positive for AFB testing. diagnose of
  tb is made. There is a skin test call PPD test
  for screening. a positive PPD could mean a person
  has tb or just being exposed to tb.
• Q How is TB currently being treated?
• A treat with multiple antibiotics for at least
  9 months

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Interview (continued 2)

• Q If someone gets a vaccine for TB, is it still
  possible to get TB?
• A BCG is the only vaccine developed, but it is
  not effective. doctors already stopped using it.
• Q How well can a person carry on normal daily
  activities if they have this disease?
• A it depends on the severity. most people can
  return to regular work after about 2 wks
  treatment.
• Q Is Multi Drug resistant TB curable?
• A it is a very serious problem. we try to use
  newer antibiotics and put patient on longer
  treatment. but certainly there are still people
  die from multidrug resistant tb.

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Conclusion

• The reason I chose the disease TB is because in
  5th grade, when I wrote a historical book report
  about a boy whose whole family was eliminated by
  the disease , consumption (another name for TB),
  I decided to find out more.
• What I learned was that before TB is active, it
  stays latent. I also did not know that even now,
  TB deaths in the world are still increasing
  especially in places where HIV is a problem.
• What I think is the most important source for
  this report is the website http//en.wikipedia.org
  /wiki/Tuberculosis.
• what I still want to know, is how did the first
  human get TB if you can only get it from another
  person. And if TB came from cattle, then how did
  they get it? Is it similar to bird flu or is it
  something else?
• I think my strengths in this report are
  researching a lot and learning many things. My
  weaknesses are time management.

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Bibliography

• http//www.info.gov.hk/tb_chest/contents/c11.htm
• http//en.wikipedia.org/wiki/Tuberculosis
• http//www.lungusa.org/site/pp.asp?cdvLUK9O0Eb3
  5778
• http//www.tac.org.za/nl20060621.html
• http//www.who.int/tb/en/
• http//www.besthealth.com/HealthEncyclopedia/Dise
  ase/article?subcatDiseaseacAlgenptid1gcid
  77cid55468
• Wong, Jean. interview December 16, 2006, Los
  Altos, CA
• Barnard, Bryn. Outbreak - Plagues that Changed
  History. Pg . 28 -33. 2005
• Landau, Elaine. Tuberculosis.pg.1-53. 1995

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THE END