Tuberculosis Flashcards
what is the main causative agent if TB
mycobacterium tuberculosis(main in people)
mycobacterium bovis(primarily bovid, but it is zoonotic)
what was the sanatorium movement(climatotherapy) to prevent TB
hospitals for TB where patients were placed with full access to fresh air started by edward trudeu in US
supported fresh air and good nutrition theory
established by germans
how is TB transmitted
inhalation of aerosols(sneeze, cough, talk) over close exposure
zoonotic is spread through drinking/eating contaminated cow products
latent TB infection vs TB disease
latent:
-lives but doesn’t grow in body
-no symptoms
-no transmission
Disease
-active and grows in body
-symptomatic
-transmissible
-can cause death if untreated
what tests are used to detect TB
-mantoux tuberculin skin test
-sputum smear test
-sputum bacterial culture
-chest x-ray
-interferon-gamma release assay
-PCR
which countries account for 2/3 of TB cases
india
indonesia
china
philipines
pakistan
nigeria
bangladesh
democratic republic of congo
how is TB treated
multidrug antimicrobial therapy for 5-6 months
DOTS approach to TB treatment
monitoring the patients either at clinics or at home to ensure they’re taking the TB treatment
reasons for resurgence of TB in US in early 1990s
shift to urban lifestyle
increase population density
squalor and malnutrition
pollution
immigration
biggest challenge in treating TB
you have to take multiple medications daily for sometimes up to 9 months which is easy to mess up
use and limitation of BCG vaccine
can be useful for newborns, but does not provide protection for adults
2 relevant mycobacterium species related to M. tuberculosis and M. bovis
mycobacterium avium(birds)-transmissible to immunocompromised
mycobacterium leprae(leprosy)-armadillos are natural reservoirs
what disease has killed more than any other infectious disease in history
tuberculosis
how many people globally from TB a year? how many die?
ill: 8-10 million
death: 1.5 million
what states in US contribute most TB cases? why?
california
texas
florida
new york
they are all big spots for migration
what is a tubercule
small lump in an organ or on the skin
who coined the tern tuberculosis? when?
Johann Schonlein in 1832
other names for TB throughout history
phthisis: greek for chronic wasting
consumption
kings evil(scrofula)
lung sickness
lupus vulgaris(TB of skin)
potts disease(TB of spine)
white plague
scrofula (the kings evil)
what did it attack?
where was it common?
how was it thought to be healed?
-attacked lymph node and caused it to enlarged
-common in medieval europe
-thought only touch of king and a coin could heal it
pott’s disease
what does it attack/cause
attacks the spine causing a shift in the vertebral column
what type of TB was found in mummies from the bronze age
pott’s disease
romanticism of TB
skinny and pale with flushed cheeks from fever was considered attractive in victorian era, many would fake illness to
what percent of American city dwellers in the early 1900s died of TB
25%
what scientist was the first to present plans for cities that would not promote illness(in europe)? what were “consequences” of his plan
Baron Georges Haussmann
much of medieval paris was destroyed to imrpove ability for public health
who discovered/theorized the cause of TB? when?
robert koch on march 24th, 1882
how did US fight TB spread
-public health measures
-legislation against spitting in street
-testing for disease
-public service announcements to cover when coughing
-controlling immigration
how did different cultures recommend treating TB before medicine was available
romans-sea voyages
english-sea bathing
germans-sanitoria(clean air and nutrition)
what ended the sanatorium movement
statistical evidence did not support the theory, by 1940s incidence of TB dropped due to improved drug treatment
characteristics of mycobacteria
-complex cell walls rich in glycolipids
-thick cell wall helps resist phagocytosis, antibodies, and entry of antimicrobials
-slow growth rate
what percent of people infected with TB do not immediately develop symptoms? what percent of those never develop symptoms in their life?
95% of infected have no development
85-95% of asymptomatic never have symptoms
explain tuberculin skin test for TB
purified protein of TB(tuberculin) is injected intradermally, then looked at 48-72 hours later
15 mm or greater in normal people or 5 mm or greater in immunocompromised indicates illness
how is TB tested for in cattle
caudal fold tuberculin(similar to tuberculin skin test), protein is injected in the skin under the animals tail
reasons for return of TB in US
-HIV epidemic
-immigration from endemic areas
-increase in homelessness, and drug use
-dismantling of public health infrastructure
-spread of drug resistant TB
who discovered streptomycin why does it as a single-agent treatment not work against TB?
discovered by salman waksman and albert schatz as working against TB
TB develops resistance to it rapidly
TB treatment challenges
-tubercules prevent efficient penetration of agents
-prolonged treatment allows bacilli longer time to develop resistance
different antimicrobial agents used to treat TB
isoniazid
pyrazinamide
rifampicin
ethambutol
T/F there is currently only one vaccine for TB
TRUE
what type of vaccine in the BCG vaccine
live attenuated
