tuberculosis paige derouin. history began infecting the first human ancestors as long as 500,000...
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TUBERCULOSIS
Paige Derouin
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History
• Began infecting the first human ancestors as long as 500,000 years ago
• In 1882 – claimed the lives of 1 in 7 people • Ran rampant in crowded European and American cities• March 24 – Robert Koch discovers Mycobacterium
tuberculosis• Koch’s discovery allowed scientists to begin working on a
treatment and vaccine for TB.
• 1908 - Albert Calmette and Camille Guérin: BCG vaccineo First used in 1921 preventatively
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History Cont’d
• 1943 - microbiologist Selman Waksman discovered streptomycin
• 1970s – Most people believe TB is completely irradiated
• 1998 – genetic sequencing of Mycobacterium tuberculosis
• 2006 – first case of extensively drug resistant TB in South Africa
• 2008 – 49 countries reported cases of extensively drug resistant TB
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Incidence
• In 2008 highest incidence was in Southeast Asia
• 98% of TB related deaths occur in developing countries
• In the US, there were 4.2 cases per 100,000 people in 2008• Most of the US cases occurred in Florida,
Texas, California, and New York
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World Incidence 2006
World map showing reported cases of tuberculosis per 100,000 citizens. Red = >300, orange = 200-300; yellow = 100-200; green 50-100; blue = <50 and grey = n/a.
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Mycobacterium tuberculosis
• Rod shaped, gram positive bacterium
• Infection begins with phagocytosis into a macrophage
• can remain inside the host in a dormant form and reactivate later
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Diagnosis
Diagnosis is based on: Symptoms
Producing cough, chest pain, night sweats, fatigue, fever
Medical history TB tests
Tuberculin Skin Test Blood Tests
Chest X-Rays Diagnostic microbiology
Sputum smear – acid-fast bacilli
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TB Tests
Tuberculin Skin Test Injection of fluid into the skin of the lower arm 48-72 hours later – checked for a reaction Diagnosis is based on height of the skin
Blood Test Newer test Based white blood cells’ response to the test Results available in 24 hours http://www.youtube.com/watch?v=s3v8M2Q6A
GI&feature=channel
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Treatment
• Latent TB• Not symptomatic or contagious • Usually treated with Isoniazid for 9 months• Confirmed with a chest X-Ray
• Infectious TB• Treatment is very expensive• Treated in phases - Isoniazid, Rifampicin,
Pyrazinamide and Ethambutol1. Usually 3 drugs2. 2 different drugs
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Treating Drug Sensitive TB
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Treating Drug Resistant TB
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Treating Extensively Drug Resistant TB
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Problems with Treatment
Very long treatment Large number of drugs is expensive Resistant Strains 3rd World countries
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Steps to Prevention
WHO’s Stop TB Strategy DOTS – reduce deaths
from TB by 50% by 2015, eliminated by 2050
March 24 – World TB Day
Research for a new vaccine to replace or boost BCG
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Works Cited
“I am stopping TB” image. : http://www.tac.org.za/community/files/stop-tb_medium.jpg
Treating extensively drug resistant TB: http://www.niaid.nih.gov/topics/tuberculosis/Understanding/WhatIsTB/ScientificIllustrations/Pages/extensivelyDrugResistantIllustration.aspx
Treating drug resistant TB: http://www.niaid.nih.gov/topics/tuberculosis/Understanding/WhatIsTB/ScientificIllustrations/Pages/multidrugResistantIllustration.aspx
Treating drug susceptible TB: http://www.niaid.nih.gov/topics/tuberculosis/Understanding/WhatIsTB/ScientificIllustrations/Pages/firstLineIllustration.aspx
Mycobacterium: http://www.students.stedwards.edu/aruiz5/interview.htm
World Incidence: http://commons.wikimedia.org/wiki/File:Tuberculosis_reported_cases_2006.PNG