Tuberculosis Is a Deadly Disease - Term Paper Example

Tuberculosis is a deadly disease cause by an invading bacterium inside the body. It mostly affects the lungs, and it then known as pulmonary tuberculosis. The disease’s reach is not limited to that however, and can also spread to other parts of the body, such as the nervous system or the circulatory system. Over one third of the world’s population now had this virus, and the rate of new infections of the bacterium are reaching about one every second. A disease with such a strong showing world wide, with 2 billion people world wide is a serious concern for everybody. In 2004, “mortality and morbidity statistics included 14.6 million chronic active TB cases, 8.9 million new cases, and 1.6 million deaths” (http://en.wikipedia.org/wiki/Tuberculosis). Hopefully, with the developing prevention programs, as well as the current research on vaccines, a good treatment and vaccine program can be found, in order to help contain and stop the spread of this deadly disease. The disease is caused by the bacterium Mycobacterium tuberculosis, which leads to a bacterial infection. Tuberculosis can develop a myriad of ways, from inhaling droplets of it present in the air from another person’s cough or sneeze, or from various other forms of contact. Out of the people infected with the disease, most of them will have it contracted in their lungs. Symptoms of the disease include a cough lasting for more than three weeks, chest pain, and even coughing up blood. Most of them will also continue on their lives normally and live through the infection and never suffer any trace from the disease again. Tuberculosis a “manifests itself in the lung where bacteria reside in granulomatous lesions. The high bacterial burden in lesions causes caseation and cavitation, which destroy the lung and provide access to the alveolar and blood system. Patients suffer from impaired lung function, mycobacterial dissemination to other organs and are contagious. Although extrapulmonary tuberculosis is less frequent, virtually all organs can be affected. Specific pathologic features depend on the type of organ affected”( http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6W7H-4HCMSMY-1&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=207f71826f0cdec5ed055b55dd1fecda). A minority of people, especially those with suppressed or weakened immune systems can find Tuberculosis a pain to deal with, and the disease can continue to become progressively worse throughout its stages of development. Many other groups are also at risk of catching the disease, “for example, those with AIDS , those undergoing chemotherapy , or transplant recipients taking antirejection medications -- are at higher risk for progression to disease or reactivation of dormant disease. In pulmonary TB, the extent of the disease can vary from minimal to massive involvement. Without effective therapy, the disease becomes progressively worse. The risk of contracting TB increases with the frequency of contact with people who have the disease, with crowded or unsanitary living conditions and with poor nutrition. Recently, there has been an increase in cases of TB in the U.S. Factors that may contribute to the increase in tuberculosis infection in a population are an Increase in HIV infection, Increase in number of homeless individuals (poor environment and poor nutrition), and the appearance of drug-resistant strains of TB.( http://www.umm.edu/ency/article/000077.htm). This gives the disease a new opening in which is can continue to spread, and also leaves many people at risk of contracting this deadly disease. The disease is spread by people who have the disease when they either cough, sneeze, spit, or talk. One sneeze can send about 40,000 droplets full of the infection. A person with the disease can spread it to 10-15 people a year with prolonged contact. By spreading this fast, “over one-third of the worlds population has been exposed to the TB bacterium, and new infections occur at a rate of one per second. Not everyone infected develops the full-blown disease; asymptomatic, latent TB infection is most common. However, one in ten latent infections will progress to active TB disease, which, if left untreated, kills more than half of its victims” ( http://en.wikipedia.org/wiki/Tuberculosis). Tuberculosis is often a difficult disease to diagnose, because of how hard it is to grow the bacterium inside laboratory conditions. Various tests must be done, including x-rays, smears, cultures, skin tests, as well as a look at past medical history. New ways of faster more accurate types of detection of the disease are underway, hoping these quicker ways of detection can help with controlling the disease. Another reason it is difficult to diagnose this disease is the fact that is can sometime pop up with few noticeable symptoms, and often times these symptoms are no noticeable until the disease is already quite underway in its development cycle. These symptoms including “loss of weight, loss of energy, fever, prolonged cough, and night sweats” (http://www.emedicinehealth.com/tuberculosis/page3_em.htm) are also symptoms that could easily be blamed on another disease or infection. This makes it quite difficult to track exactly what is going on in the person’s body, and makes it even harder for doctor’s to discover tuberculosis early. All of the above reasons make testing for this disease tricky and complicated work. However several tests can be given to try to rule out, or discover the presence of this disease in the body including “examination of the lungs by stethoscope, Enlarged or tender lymph nodes may be present in the neck or other areas, Fluid may be detectable around a lung and Clubbing of the fingers or toes may be present. Other tests include Chest x-ray, Sputum cultures, Tuberculin skin test, Bronchoscopy, Thoracentesis, Chest CT, Interferon-gamma blood test such as the QFT-Gold test, or in rare cases Biopsy of the affected tissue”( http://pennhealth.com/ency/article/000077.htm). Of those unlucky people who do develop the disease, its first stage, tuberculosis pleuritis normally only developed in about ten percent of the cases with the earlier stage of the disease. This double disease “occurs from the rupture of a diseased area into the pleural space, the space between your lung and the lining of the abdominal cavity” ( http://www.emedicinehealth.com/tuberculosis/page3_em.htm). This disease also may go away and become dormant, only to flare back up and appear again at a later date. Treatment for the drug is given in the form of antibiotics. Long terms use of these antibiotics are needed in order to clear the entire bacterium from the body, and is often treated with a combination of antibiotics. However, there are risks involved when combining the different antibiotics, even thought it is helpful incase the bacterium becomes drug resistant to one of the antibiotics. In order words, no perfect cure exists for tuberculosis, and researches area desperately trying to come up with a working vaccine to combat the spread of this deadly disease. Even with the fast spreading nature of the disease, prevention is still underway. In 1993, the World Health Organization declared that the fast spreading Tuberculosis disease was in fact a global health emergency, and a global plan has gone into effect which aims to save lives from Tuberculosis between 2006-20015. The prevention of Tuberculosis is split into two waves of attack. In the first wave, people who are known to have Tuberculosis are treated, and all people with immerse contact with that person are also found and treated. This is to try to prevent the further spread of the disease, to contain all the people who have contracted the disease, as well as to help doctor’s quickly identify all people who may have become infected in order to help them receive the proper treatment as soon as possible. This first wave of action can also involve taking and testing several members of the high risk group and seeing if any of them have unknowingly contracted the disease. The only other prevention is trying to stop the disease in children, which is what the vaccines are used for. The second step in prevention the spread of the deadly disease is vaccines. Vaccines are given to children; however an effective vaccine is not available for adults. In some countries, the vaccine is being required to be given to all children under the age of three to try to combat the rapidly spreading bacterium. Many countries “use BCG vaccine as part of their TB control programs, especially for infants. This was the first vaccine for TB and developed at the Pasteur Institute in France between 1905 and 1921. [However, mass vaccination with BCG did not start until after World War II. The protective efficacy of BCG for preventing serious forms of TB (e.g. meningitis) in children is greater than 80%; its protective efficacy for preventing pulmonary TB in adolescents and adults is variable, ranging from 0 to 80%. In South Africa, the country with the highest prevalence of TB, BCG is given to all children under the age of three.] However, the effectiveness of BCG is lower in areas where mycobacteria are less prevalent, therefore BCG is not given to the entire population in these countries. In the USA, for example, BCG vaccine is not recommended except for people who meet specific criteria: Infants or children with negative skin-test results who are continually exposed to untreated or ineffectively treated patients or will be continually exposed to multidrug-resistant TB or Healthcare workers considered on an individual basis in settings in which a high percentage of MDR-TB patients has been found, transmission of MDR-TB is likely, and TB control precautions have been implemented and were not successful”(http://en.wikipedia.org/wiki/Tuberculosis#Prevention). Even today, tuberculosis remains a huge medical threat, and is still largely unsolved by the medical world. With all the developments, many people still worry that they will not be enough, and that further vaccines and research will need to continue to develop until a cure is one day finally found. Several new methods of preventing the disease are also underway. One such vaccine, when combined with chemotherapy, can quicken the decline and removal of the disease from the body. Other various forms of different vaccines are also being researched, in the hopes that a stronger one can be found. The first recombinant vaccine began being tested in 2004 , and in 2005 a “study showed that a DNA TB vaccine given with conventional chemotherapy can accelerate the disappearance of bacteria as well as protect against re-infection in mice; it may take four to five years to be available in humans.] A very promising TB vaccine, MVA85A, is currently in phase II trials in South Africa by a group led by Oxford University, and is based on a genetically modified vaccinia virus. Because of the limitations of current vaccines, researchers and policymakers are promoting new economic models of vaccine development including prizes, tax incentives and advance market commitments” (http://en.wikipedia.org/wiki/Tuberculosis#Prevention). In June of 2006 these new candidates reached clinical testing on patients. The original findings of these trials showed many positive improvements in the vaccines, however there is still much work that is needed to be done. There is still a lot about the disease that we do not understand, and despite these new breakthroughs, there is a lot more research and testing that needs to be done, and new findings that need to be furnished. These findings “will advance further improvements in vaccine development. These include the potential role of cross priming to induce more potent T-cell responses, the role of memory T cells and regulatory T cells in sustaining or curtailing optimal immune responses, respectively, as well as the involvement of cytokines in T-cell migration to no immunologic tissue sites and in the generation of memory. Knowledge about basic mechanisms underlying optimum protection will not only have a direct impact on future vaccine design against tuberculosis but also help in the formulation of a set of biomarkers with predictive value for vaccine efficacy assessment”( http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6VS1-4K5ST12-5&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=5c986e65dfcd12b4a643f59acb1942c2). Despite the work that still needs to be done on the vaccine side of the disease, many new breakthroughs have helped how doctors can best and most easily take notice of the early stages of tuberculosis. A new study shows that radiographic findings are more reliable than the usual clinical symptoms that most people have been using to diagnose this disease. This new study also hopes that its findings can help reduce the number of people who are put under watch or isolation, as it shows a much more effective way to test for the disease, and showed that the radiographic findings are near conclusive, and are much more efficient and helpful to doctors trying to diagnose tuberculosis. It also helps reduce the number of people who needs to be isolated, which was inflating hospital costs. The team conducted a retrospective study to help try to narrow down the best possible way to test for tuberculosis. The study included “3,325 patients placed in respiratory isolation at Henry Ford Hospital from January 2002 to December 2005(http://www.docguide.com/news/content.nsf/news/852571020057CCF68525720A006C4D18). During the study, the researchers were able to find that 43 patients with respiratory specimens that were positive for the bacterium that causes tuberculosis. Of those 43, 34 tested positive for acid fast bacilli on test smears, and 27 of them were identified on the very first sputum culture. The connection was also further developed during the course of the study, when a strong percentage linked the findings on the smears with the findings on radiological chest x-rays. The study found that “presence of acid fast bacilli on sputum smears was found with radiological findings on chest x-rays (67.4%), which yielded a P value less than .0001, and with chest computed tomography (82.35%), which also yielded a P value less than .0001” and also concluded that “the radiographic findings are the most important ones to consider when it comes to diagnosing pulmonary tuberculosis” (http://www.docguide.com/news/content.nsf/news/852571020057CCF68525720A006C4D18). An even more recent study was done in the United States recently, that concluded “Tuberculosis (TB) is the most important zoonotic bacterial disease in nonhuman primates (NHP). The current diagnostic method, the intradermal palpebral tuberculin test, has serious shortcomings” (http://www.newsrx.com/article.php?articleID=815384). It is this type of research that needs to be continued in order to properly find all the information that is needed on this disease. Only then will we be able to properly treat it and combat the spread of this disease. To this day, various studies are being undertaken to try to develop the best possible ways of testing for, and treating, this deadly disease. Even with all the advancements that have sprung up over the past years however, there is still much work that is needed to truly understand and stop the spread of this deadly disease. Works Cited: Gagnon, December 27, 2007 Radiographic Findings, Not Clinical Symptoms, Helpful for Diagnosis of Pulmonary Tuberculosis in Hospitalized Patients: Presented at IDSA. from Peer View Web site: http://www.docguide.com/news/content.nsf/news/852571020057CCF68525720A006C4D18 Kaufmann, December 27, 2007 Recent findings in immunology give tuberculosis vaccines a new boost. from Science Direct Web site: http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6W7H-4HCMSMY-1&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=207f71826f0cdec5ed055b55dd1fecda December 27, 2007 Tuberculosis. from Wikipedia Web site: http://en.wikipedia.org/wiki/Tuberculosis December 27, 2007 Pulmonary tuberculosis. from University of Maryland Medical Center Web site: http://www.umm.edu/ency/article/000077.htm December 27, 2007 Pulmonary tuberculosis. from University of Pennsylvania Health System Web site: http://pennhealth.com/ency/article/000077.htm December 27, 2007 Tuberculosis Symptoms. from Emedicine Health Web site: http://www.emedicinehealth.com/tuberculosis/page3_em.htm December 27, 2007 Studies in the area of tuberculosis reported from K.P. Lyashchenko and co-researchers. from News Rx Web site: http://www.newsrx.com/article.php?articleID=815384 Read More