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Tuberculosis INTRODUCTION: Tuberculosis, or TB, is an infectious bacterial disease caused by Micro bacterium Tuberculosis, which most commonly affects the lungs .It is transmitted from person to person via droplets from the throat and lungs of people with the active respiratory disease. TB can affect any other organ of the body, for example, lymph nodes, brain, and genitals. Includes coughing (can be sometimes bloody), fever, and weight loss. Bacteria can remain inactive for many years. People with inactive infection do not pass the disease to others. Bacteria become “active” when people become weak by others diseases. (Malnutrition,diabetes,andHIV)
HISTORY OF TB: Tuberculosis is believed to have been present in humans for thousands years, since tubercular remains have been found in prehistoric humans. Like the Egyptian mummies, in 4000 B.C In 1679, Sylvius wrote his Opera Media in which he showed he was the first to identify tuberculosis and the changes in the lungs and other of the body. Also it appeared references of the infection of tuberculosis in 17th century, Italian Medical Literature. During 17th and 18th centuries, tuberculosis caused up to 25 % of all deaths in Europe. Just in 1946, Laniazid introduced the first antibiotic to destroy the tuberculosis. Called isoniazid that became available in 1952.But because of the variety of its symptoms, TB was not identified as a complete disease until the 1820s and was not named tuberculosis until 1839 by J.L.Schonlein. That is why the patients of the 19 th century, were isolated to not infect other people, and given treatments such as injecting air into the lungs. Since during the first half of the 20 th century, no effective treatment was available and just in 1946 an antibiotic was introduced, so on in the 19 th century they made a surgery called thoracoplasty that was based in decreasing the lung size.
INFECTION: How does TB infection spread?
TB bacteria spread from person to person through the air. When a person with contagious TB disease coughs, laughs, or speaks releases bacteria into the air, which can maintain in the air for many hours. But infection only occurs if TB bacteria are inhaled. A person is more likely to become infected with TB if he/she spends several hours in a poorly ventilated room with a person who is breathing out TB bacteria into the air. Tb is not spread by handling objects that the patient has come into contact with; e.g. Dishes, glasses, sheets or clothing. What is the difference between TB infection and TB disease? TB infection: you have TB bacteria in your body, but they are asleep or inactive, A person with infection usually has a positive TB skin test and a normal chest x-ray, he/she doesn’t have any symptoms and cannot spread TB to others. TB disease: TB bacteria is in the body awaken or active. A person with TB disease is sick and may spread TB to others. He/she has a positive skin test and abnormal chest x-ray and symptoms of TB disease, and needs to be medicated to become well. TB infection may turn into TB disease, the first two years after becoming infected is when TB infection is more likely to turn into disease. What does having TB infectin mean? When TB bacteria enter the body, body defenses control the germs by building a “wall” around them. The germs can stay alive inside the wall for years in an “inactive”state. While TB germs are inactive, they cannot harm the person and they cannot spread the bacteria to other people. The person is infected but not sick and is unlikely to be aware that he or she is infected. Inactive TB bacteria cannot hurt you but, of the body defenses are weakened for any reason, inactive TB bacteria may weaken the “walls” and become active and multiply to become disease.
SYMPTOMS: People who are carrying TB may not notice any symptoms of illness until the disease is quite advanced. TB bacteria may spread through the blood to all parts of the body producing the following symptoms:
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Weight loss
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Fever
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Chills
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Night sweats
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Weakness or fatigue
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Loss of appetite
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Long coughs
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Pain in the chest
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Coughing up blood or sputum
Although this symptoms might be blamed on another disease. Chest xrays should be carrying out to make sure if the bacteria has been develop in the lungs. Tuberculosis pleurits may occur in people who have the lungs disease from tuberculosis. TB pleuritis disease occurs from the rupture of a diseased into the pleural space. The space between the lung and the lining of abdominal cavity. About 15 % of people who develop tuberculosis in other organs may suffer from: •
Lymph nodes
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Genitourinary tract
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Bone and joint sites
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Meninges
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Lining covering outside of the gastrointestinal tract
TREATMENT: Specific tests should be make to have a diagnosis and determine if the person is active or inactive to the disease. TB tests include: •
TB skin test (PPD)
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TB blood test
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Chest xrays
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Sputum analysis
TB – Skin test: Tuberculosis skin test or PPD test is a test used to determine if someone has developed TB infection. This test is based on the fact that the infection produces a delayed type hypersensitivity skin reaction to certain components of the bacterium. Chest xrays: A chest xrays is a radiology test where the chest is exposed to radiation to produce an image of the chest and internal organs of the chest.
A sputum test: Shows if TB bacteria are present in the sputum. Their presence is proof of active pulmonary TB (TB disease). MEDICAL TREATMENT: A combination of antibiotics treats the infection of tuberculosis. It is a slow process and should be carrying out regularly. Medication must be taken for at least six months to avoid becoming ill with TB again. Even if the person might feel better, the process must not be cut out. •
Doctors will prescribe special medications that you must take for six to nine months.
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Two months with RIFATER
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Four months of isoniazid and rifampin ( Rifamate , Rimactane)
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ETHAMBUTOL or STREPTOMYCIN added until your drug sensitivity is known (from the results of the bacteria cultures)
It is a long treatment because the diseases grows very slowly, but also die very slowly. Doctors may also contact your relatives and friends and make sure they take a skin test and chest xrays , as they could be affected too.
PREVENTION: Large population spread of TB can also be stopped by treatments. The spread of tuberculosis and tuberculous meningitis may be prevented by the tuberculous vaccine, known as bacille Calmette Guérin (BCG).But this vaccine does not necessarily protect against pulmonary tuberculosis. Health Officials recommend the vaccine in countries or communities where the rate of infection is greater than 1%per years. For example in United States the rate of infection is very low so they don’t recommend the use of BCG.
CONCLUSION: Tuberculosis disease increases as the HIV is not controlled in poor countries and where the medical treatments are not well supply. In the future a highly control of HIV should decrease the frequency of tuberculosis.