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Tuberculosis May Become A Global Threat Again
Iphtashu Fitz writes "The journal Nature Medicine is due to release a report today on how highly drug-resistant strains of tuberculosis are on the verge of becoming a global epidimic. Strains of TB that are highly resistant to antibiotics are becoming increasingly prevalent in places like Russia, eastern Europe, and China, and only small changes are required to make these strains start spreading quickly. Treatment for multiple-drug-resistant strains of TB requires a carefully monitored cocktail of drugs taken for months on end, a regimin that many, especially in poorer countries are unlikely to follow to completion. The strategy used by the World Health Organization to combat TB, the "directly observed treatment, short course" or DOTS, involves using trained health workers to watch patients take their long courses of drugs, since even a little carelessness could result in TB mutating into a more drug resistant form within the patient." Oh, Alexander Fleming ? where art thou now?
Oh, Alexander Fleming? where art thou now?
He's right here, silly.
Trolling is a art,
Not sarcastic at all - The Gates Foundation is one of the major forces fighting TB today.
How long has it been, at least 400-600 years since a nice big population dwindling event has occurred...
The 1918 Flu Pandemic probably killed more people worldwide than The Black Death. The Black Death killed a larger percentage, though.
You only use 2% of your DNA
Alright, I'm a practicing lung doctor so I've got to say a little bit.
:)
Change in the skin TB status (or PPD) suggests a recent infection with TB. Placing someone of INH for 6 to 9 months greatly decreases the risk of someone developing active TB in the future.
The amount of exposure and the potential risks for reactivation of the TB are all evaluated before INH is prescribed.
INH can cause liver problems... and avoiding alcohol is a must.
To answer the parent's other question--
Using INH for a long enough duration will not cause resistence. Dead bugs can't develop resistence.
Yes, it can survive forever.
We see people that were exposed 20-30 years ago and have reactivation when placed on steroids or chemotherapy.
In the grand scheme of things, TB may be getting worse worldwide, but here in the states it seems well controlled. We have a huge immigrant population, and I have seen on a couple cases of active TB over the last 5 years.
I come to read slashdot in between patients to get away from medicine... please quit running these medical stories. They remind me that I'm not a real geek.
AC
Just a little background info, blatantly ripped off of this website: http://encyclopedia.thefreedictionary.com/mycobact erium
Sorry for the crappy formatting.
Mycobacterium is the only genus in the family Mycobacteriaceae of bacteria. This genus includes many pathogens known to cause serious diseases in mammals, including tuberculosis
Tuberculosis, also called TB, phthisis, consumption, and nicknamed the white plague, is the most common infectious disease in the world today. It is caused by a bacterium, usually the Mycobacterium tuberculosis but any member of the so called Tuberculosis complex will do. If left untreated, more than 50% will die in a few years time. It causes about 2-3 million deaths per year out of 9-10 million cases and is especially prevalent in undeveloped, tropical countries.
and leprosy
Hansen's disease, also known as leprosy, is an infectious disease caused by infection by Mycobacterium leprae. The modern name of the disease comes from the discoverer of Mycobacterium leprae, G. A. Hansen. Sufferers from Hansen's disease have generally been called lepers, although this term is falling into disuse both from the diminishing number of leprosy patients and from pressure to avoid the demeaning connotations of the term.
Most mycobacteria are classified into two categories, the fast-growing kind and the slow-growing kind, and most mycobacteria share some common characteristics:
* They are widespread organisms, typically living in water (including tap water treated with chlorine) and food sources.
* They can colonize their hosts without the hosts showing any adverse signs. For example, millions of people around the world are infected with M. tuberculosis
Mycobacterium tuberculosis is the bacteria that causes most cases of tuberculosis. Its genome has been sequenced.
It is a Gram-positive aerobic mycobacterium that divides every 16-20 hours. This is extremely slow compared to other bacteria which tend to have division times measured in minutes (for example, E. coli can divide roughly every 20 minutes). It is a small rod-like bacillus which can withstand weak disinfectants and can survive in a dry state for weeks but can only grow within a host organism.
but will never know it because they will not develop symptoms.
* Mycobacterial infections are notoriously difficult to treat. The organisms are hardy and can survive long exposure to antibiotics, which naturally leads to antibiotic resistance Antibiotic resistance is the ability of a microorganism to withstand the effects of an antibiotic. Antibiotic resistance develops through mutation or plasmid exchange between bacteria of the same species. If a bacterium carries several resistance genes, it is called multiresistant or, informally, a superbug.
Most mycobacteria are susceptible to the antibiotics clarithromycin and rifamycin, but antibiotic-resistant strains are known to exist.
* Mycobacteria tend to be fastidious (difficult to culture), sometimes taking over two years to develop in culture.
Species * M. tuberculosis, which causes tuberculosis Tuberculosis, also called TB, phthisis, consumption, and nicknamed the white plague, is the most common infectious disease in the world today. It is caused by a bacterium, usually the Mycobacterium tuberculosis but any member of the so called Tuberculosis complex will do. If left untreated, more than 50% will die in a few years time. It causes about 2-3 million deaths per year out of 9-10 million cases and is especially prevalent in undeveloped, tropical countries.
* M. leprae
Mycobacterium leprae, also known as Hansen's bacillus, is the bacterium that causes leprosy (now called Hansen's disease). It is an intracellular, pleomorphic, but usually rod shaped, acid fast, gram positive, aerobic only remotel
Si la vida me da palo, yo la voy a soportar Si la vida me da palo, yo la voy a espabilar
Mostly false...
Prisions are a huge breeding ground for TB. One of my partners just saw somebody that had baseball-sized masses growing from several sites on his body. He wasn't referred to a doctor for several months. Biopsy of these lesions showed tons of TB.
Medical care in the prisions is very sub-standard.
It is true that if you do not take your TB drugs as prescribed, you will be put into prision. Yes, America will force you to take your TB drugs... to keep you from infecting others.
However, most prisioners are in and out of jail too often to really get adequate screening for infectious diseases.
AC
Excellent advice.
However, it does not work this way in every part of the world. In third world countries, antibiotics are not as regulated as they are in G8 countries.
Pharmacists there dispense antibiotics freely without prescription, since many poor people go to the pharmacist for a cure, without having to pay the doctor's fee. This may not be purely legal, but everyone does it.
This causes more and more strains to be resistant to antibiotics, and many of the new ones become ineffective quickly.
This is why we see some almost eradicated diseases (e.g. TB in this case) revitalize and become more virulent.
2bits.com, Inc: Drupal, WordPress, and LAMP performance tuning.
The story about the nicaraguan deaf children, and this tuberculosis story were both covered thouroughly in the PBS documentary series Evolution. Portions of the relevant segments are available online on the PBS website:
Deaf Children Video
Tuberculosis Video