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Tuberculosis

Tuberculosis. Paige Derouin. 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

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Tuberculosis

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  1. Tuberculosis Paige Derouin

  2. 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 vaccine • First used in 1921 preventatively

  3. 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

  4. 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

  5. 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.

  6. 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

  7. 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

  8. 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=s3v8M2Q6AGI&feature=channel

  9. 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 Ethambutol • Usually 3 drugs • 2 different drugs

  10. Treating Drug Sensitive TB

  11. Treating Drug Resistant TB

  12. Treating Extensively Drug Resistant TB

  13. Problems with Treatment • Very long treatment • Large number of drugs is expensive • Resistant Strains • 3rd World countries

  14. 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

  15. 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

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