Symptoms of Tuberculosis

Symptoms of Tuberculosis | Symptoms of Tuberculosis and the One Minute Treatment - By: Paul John Allen


Symptoms of tuberculosis may be slow in developing and initially resemble those of influenza - general malaise, coughing, loss of appetite, night sweats, chest pain, and low grade fever. At first, the cough may be nonproductive, but as the disease progresses, increasing amounts of sputum are produced. As the condition worsens, fever, night sweats, chronic fatigue, weight loss, chest pain, and shortness of breath may occur, and the sputum may become bloody. In advanced cases tuberculosis of the larynx can occur, making it impossible to speak above a whisper.

Diagnosis of tuberculosis
Patient history and physical examination and chest x-rays. Tuberculin skin test and a small amount of protein derived from mycobacteria is injected into the skin on the arm, and the area is examined after 48 to 72 hours. A slightly raised, hard, red patch of skin at the site indicates the presence of tuberculosis ( although not necessarily active disease). However, a positive tuberculosis skin test may also from prior immunization with BCG. Sputum smears and culture. Examining sputum for organisms are present; smears are negative, however, in many patients who have tuberculosis and some positive smears may be caused by organisms other than tuberculosis. The results of the culture may take three to six weeks to develop. A positive culture confirms diagnosis. Bone marrow biopsy. A sample of bone marrow is usually taken from the hip bone. Bronchoscopy (the use of a thin, hollow, flexible tube passed through the mouth into the windpipe to view the main bronchial passages).

Bringing your experience about the symptoms of tuberculosis to the next step you will encounter that there is a powerful all natural therapy that we have not discuss above which will help you eliminate all symptoms of tuberculosis in a very drastic way its what we call The One Minute Cure For All Diseases. Learn what you can start doing today! Don't wait. Take action right now!

……………………………………………………………………………………

Symptoms of Tuberculosis | Symptoms of Tuberculosis with Some Recommended Herbs for Treatment - By: Paul John Allen


Tuberculosis, also known as TB, is a chronic infection with a specific type of bacterium (Mycobacterium tuberculosis) that usually affects the lungs. Although contagious, TB is not as easy to catch as other respiratory infections, since repeated and prolonged exposure to airborne particles from coughing or sneezing is usually necessary to permit sufficient numbers of the bacteria into the lungs. Over crowded, impoverished living conditions and frequent contact with others who are sick with TB are significant risk factors. In the United States a large proportion of people with TB were born in countries with high rates of the disease.

Symptoms of tuberculosis
" Persistent cough, possibly producing bloody sputum.
" Chest pain.
" Shortness of breath.
" Fever.
" Fatigue.
" Night sweats.
" Loss of appetite; weight loss.

Symptoms of tuberculosis with some recommended herbs for treatment
Clear lungs from Ridgecrest herbals is a Chinese herbal formula that relieves bronchial and lung congestions. Butchers broom, calendula, cayenne (capsicum), chamomile, peppermint, and yarrow have anti-inflammatory properties. Lung tonic from herbs, etc. supports lung function. Elecampane, ephedra, goldenseal root, horehound, licorice, lobelia, marshmallow root, mullein, myrrh gum, and thyme have decongestant and expectorant properties. A combination Echinacea and pau d' arco tea is beneficial. Echinacea is a powerful antioxidant and bolsters the immune system; pau d' arco benefits the body by cleansing the blood and acting as an antibacterial agent, as well as possessing anti-tumor agents. Drink 3 cups of this tea daily. Or combine Echinacea tincture with equal parts of tinctures of elecampane and mullein, and take 1 teaspoon of this mixture three times daily.

Pay Close Attention To This One:

What I am about to share with you is a secret therapy that I have not discuss above that will deal effectively with all the symptoms of tuberculosis and eventually cure it, this is a secret that no one will ever share with you. This secret will really amazed you and to think that the natural therapy you'll learn is so cheap. If you truly desire to eliminate the symptoms of tuberculosis and treat it effectively I Strongly Urge You To Read The Next Page. It may well be The Most Important Message You Ever See. Follow This Link And Read Everything On The Next Page Carefully- Click Here!.


……………………………………………………………………………………………………………………………………………

Why You May Need TB testing - By: Lena Butler


Most Americans probably think of tuberculosis, or TB, as a disease that our grandparents or great-grandparents had to worry about but was cured decades ago. A century ago, it was known as “consumption” because it slowly consumed a person until the person seemed to waste away. Back then it killed one out of every seven people in the 1900s in the United States. The truth is, even though TB for the most part is controlled in the US, it is still a potentially fatal disease that we need to take seriously.

Every 20 seconds, someone in the world dies from TB. Also roughly a third of the world’s population is infected with TB. It is not a disease that has been cured and wiped off the earth. The worrying part about TB is that there are now new strains of TB which are drug-resistant.

Why is TB testing important?

TB control is taken pretty seriously in the US because at one stage, it was the leading cause of death in the country. The disease still kills more people worldwide than any other contagious disease.

In the forties, medicines were discovered which cured TB. As a result, the disease started to die down. Still, in the 70’s and 80’s TB control was slackened. This resulted in a comeback of the disease in the mid-eighties to early nineties. Since then, the US government has again stepped up efforts to control TB.

How do you catch TB?

Tuberculosis is caused by bacteria called M. tuberculosis. The bacteria usually infect the lungs. But sometimes it also infects other body parts, like the kidneys, spine, bones, and brain. If left untreated, the disease can kill.

You can catch TB if you inhale the air of someone who has TB in his lungs. The bacteria are airborne when he cough or sneeze, or even laugh, sing or talk. It’s generally not that easy to catch TB. You would have to have repeated exposure to get it.

What are the symptoms of TB?

The most common symptoms of TB are having a cough which lasts more than 3 weeks, coughing up blood, chest pain, sudden weight loss, fever and night sweats.

Which jobs require TB testing?

You are required to get a test for TB if you are a health care worker. Also if you work in any of the following places: jails, homeless shelters, mental institutions, nursing homes, migrant camps or schools.

Why do these jobs require testing?

Some jobs are considered higher-risk than others for catching TB. Healthcare workers may have more exposure to TB than other people. The disease is more likely to spread in places where many people interact, so all the institutions above are places where the disease might thrive. TB is also more likely to affect people who are in poor health, are malnourished, and have lower incomes. In addition, in some countries TB is a lot more common than in the US, thus migrant populations and ethnic minorities are considered higher-risk for TB.

How do I get tested for TB?

You can get either a blood test or a TB skin test, but the skin test is more common and less costly. The skin test is done by injecting a liquid into the skin of your forearm. Two to three days later, the skin is checked for a reaction. If the reaction is positive, it means you have been exposed to TB at some point but you may or may not have an active infection. You will need to get a chest x-ray to confirm whether you have active TB or if you are just a TB carrier. If you test positive, either way your doctor will let you know which steps to take next.

……………………………………………………………………………………………..

home remedy for Tuberculosis - By: dr.bruswiliam


According to scientific studies, three million people die from home remedy for Tuberculosis every year. A number of around eight million new discovered Tuberculosis conditions appear per year and 95% is estimated to be in developing areas. Countries like those in South America, Africa or Asia have the highest susceptibility to Tuberculosis due to the low living standards and the bad economic and social conditions.Ayurvedic herbal treatment has a definite and important role to play in the successful management of tuberculosis infection. This role has significance on several fronts. In the last five decades, it has become apparent that all currently available modern drugs for tuberculosis can be potentially toxic to the liver. This may lead to decreased appetite, inflammation of the liver, and in severe cases, irreversible damage and liver failure. There are several Ayurvedic medicines which act favorably on the liver, like Kutki These medicines, when added to the tuberculosis treatment regimes, instantly correct liver problems, and help in a rapid therapeutic response to treatment.

Latent tuberculosis infection is when a person is infected with Mycobacterium tuberculosis but does not have symptoms of disease. They are said to be asymptomatic. Active tuberculosis disease is the full-blown disease which, if not treated, will kill half of the patients. One in ten latent infections will progress to active tuberculosis disease. Typical symptoms of an active tuberculosis patient include weakness, fever, chest pain, respiratory insufficiency, fever and cough. Strains of Mycobacterium tuberculosis have become multidrug-resistant making the disease particularly difficult to treat. Treatment includes chemotherapy and a combination of different types of drug. Tuberculosis is spread by infective particles produced through coughing by patients with active tuberculosis. The air-borne particles carrying the bacteria can be inhaled by other people.Almost all spreading of tuberculosis are hidden because its carriers do not show its indication and they are not infected. However, one of 10 people will come down with this disease along the time because of the weakness of his immune system.
From 1,8 million of death in 2008 or 4.930 death in a day, a half million of them are AIDS patients. Most tuberculosis usually attack young men that are in their most productive time and most of the deaths happen in developing countries. More than half of deaths happen in Asia, like Bangladesh, China, India, Indonesia, Pakistan, and Philippine.The World Bank estimates that the disease can lose 4-7% of gross domestic income of some countries that come down with. Tuberculosis that is incurable is usually caused by medicinal treatment by halves and it often happens to patients that stop their treatments when they feel better.

Tuberculosis is a preventable disease. There are a few measures one can take to protect their health. First, you should be tested regularly. If you have an immune suppressing disease, live or work in a prison or nursing home, were born in a TB prevalent country, or have other risk factors, then a Mantoux test should be done every six months.If you test positive without symptoms, speak with your doctor about treatments to reduce the risk of developing active tuberculosis. The most important step you can do for the public and yourself is to finish the entire course of medication. Treatment that is stopped to early allows the bacteria a chance to mutate to a drug resistant form and more information on http://www.himalayahomeremedies.com/homeremedies_tuberculosis.htm .


……………………………………………………………………………………………………………………………………..

Tuberculosis - Drug Pipeline Analysis and Market Forecasts to 2016 - By: ReportsnReports


GlobalData’s report, “Tuberculosis - Drug Pipeline Analysis and Market Forecasts to 2016” is an essential source of information and analysis on the global Tuberculosis (TB) drugs market. The report identifies the key trends shaping and driving the global TB market. The report also provides insight into the prevalent competitive landscape and the emerging players expected to significantly alter the positioning of the existing market leaders. Most importantly, the report provides valuable insight into the pipeline products within the global TB sector. The global TB drugs market was worth $99m in 2009. The market is expected to decline by 2.8% during the next seven years. The TB drugs market has been well served by antimycobacterial agents and antibiotics since the 1960s. The cure rates have improved with the conventional DOTs (Directly Observed Therapy). Multi-Drug Resistant Tuberculosis (MDR-TB) has been a consequence of patient non-compliance and the long duration of therapy. Companies seem to be actively developing products for the prophylaxis and cure of TB that have lesser treatment durations. The two not-for-profit organizations, TB Alliance and the Aeras Global TB Vaccine Foundation, have partnered with pharmaceutical players in order to address the burden of TB in developed and developing nations. With the success of the ongoing clinical studies, the market is expected to witness a breakthrough in TB control and treatment. The vaccines’ primary focus would be to inhibit the infection at the first place. The global TB drugs market is heading towards a phase of decline as no launches are expected till 2016.
This report is built using data and information sourced from proprietary databases, primary and secondary research and in house analysis by GlobalData’s team of industry experts.

Scope
The scope of the report includes:
• Annualized global Tuberculosis drugs market revenue data from 2001 to 2009, forecast for seven years to 2016.
• Geographies covered in this report include the US (United States), the UK (United Kingdom), Italy, Spain, Germany, France and Japan.
• Pipeline analysis data providing a split across the different phases of development by mechanism of action and emerging trends. The key classes of mechanism of action of drugs include ATP synthase inhibitors, protein synthesis inhibitors, cell wall synthesis inhibitors, DNA gyrase inhibitors, FAS synthase inhibitors, translocase-1 inhibitors and others. The vaccine candidates have been segmented as recombinant live vaccines, recombinant protein vaccines and viral vectored vaccines.
• Analysis of the current and future market competition in the global Tuberculosis drugs market. The key market players covered are isoniazid, rifampin, pyrazinamide, ethambutol, streptomycin, rifabutin and capreomycin.
• Insightful review of the key industry drivers, restraints and challenges. Each trend is independently researched to provide qualitative analysis of its implications.
• Key topics covered include strategic competitor assessments, market characterization, the unmet needs and the implications for the future market associated with TB.

Reasons to buy
The report will enhance your decision making capability in a more rapid and time sensitive manner. It will allow you to:
• Develop and design your in-licensing and out-licensing strategies through review of pipeline products and technologies and by identifying companies with the most robust pipeline.
• Develop business strategies by understanding the trends shaping and driving the global tuberculosis market.
• Drive revenues by understanding key trends, innovative products and technologies, market segments and companies likely to impact the global tuberculosis market in future.
• Formulate effective sales and marketing strategies by understanding the competitive landscape and by analyzing the performance of various competitors.
• Identify emerging players with potentially strong product portfolio and create effective counter-strategies to gain competitive advantage.
• Organize your sales and marketing efforts by identifying the market categories and segments that present maximum opportunities for consolidations, investments and strategic partnerships.
• What’s the next big thing in the global tuberculosis market landscape? – Identify, understand and capitalize.

1 Table of contents 3
2 Tuberculosis: Market Characterization 6
3 Tuberculosis Drugs Market: Competitive Assessment 12
4 Tuberculosis Drugs Market: Pipeline Assessment 16
5 Tuberculosis Drugs Market: Implications for Future Market Competition 27
6 Tuberculosis Drugs Market: Future Players in the Tuberculosis Market 29
7 Tuberculosis Drugs Market: Appendix 37


…………………………………………………………………………………………………
Drug Resistance In Tuberculosis - By: Dr. D.S. Merchant


Definitions:
• Drug Resistant Tuberculosis

Cases of T.B. caused by an isolate of TB resistant to one of the first line anti TB drugs

PRIMARY DRUG RESISTANCE (P.D.R)
PDR is defined as resistance to one of the frontline drugs in person with TB who is not known to have previous treatment with ATT

NATURAL DRUG RESISTANCE IN WILD STRAINS (Spontaneous Mutation)
SECONDARY (ACQUIRED) DRUG RESISTANCE (A.D.R)
ADR is defined as acquiring increasing level of resistance to one or more drugs in a strain recovered from a patient undergoing ineffective therapy.

TRANSMITTED DRUG RESISTANCE (T.D.R)
TDR is said to have occurred when a single or multi drug resistant strain is recovered from patient who is high risk contact of other individual known to be shedding strain with comparable patterns of drug resistance

MULTI DRUG RESISTANCE (M.D.R)
MDR defined as resistance to two or more first line drugs. Now usually used when resistance to Rifampicin & INH is seen with or without resistance to other drugs.

Cross Resistance:
Capreomycin & Viomycin
Thiacetazone & Ethionamide

Epidemiology US:
Prevalence decreasing in US b/c of effective measures.
1991 National survey of all TB cases revealed
PDR to 1 or more drugs in 13.4%
PDR to RH in 3.2 % of Isolates
New York highest incidence 33 % of isolates 1 drug
26% to INH
19 % to RH

Epidemiology US:
In 1997 decreased to 10%
INH most common 8%
R 1.7%
S 5.9%
E 1.6%
RH 2.5%


Epidemiology UK:
GRANGES & YATES 1993 In South East ENGLAND
8.5% of Immigrant Indian subcontinent population with tuberculosis had drug resistance

Epidemiology World Wide:

Epidemiology Local:
• Rifampicin 10/125 8%
• INH 32/184 17.3%
• Ethambutol 11/124 8.8%
• Strep 8/59 13.5%
• Sensitive to all drugs 137/184 74.4%
• Resistant to 1 drug 35/184 19.8%
• Resistant to 2 drugs 9/184 4.8%
• Resistant to 3 drugs 3/184 1.6%

Institue Of Chest Disease Kotri:
16.4 % Pts did not convert to 5 drugs suggesting high prevalence of resistance

At Ash 100 Isolates Of Patients In Relapse / Retreatment Group:
No of resistance cases 60 60%
Resistance to single drug 38 38% 63%
Resistance to two drugs 18 18% 30%
Resistance to three drugs 2 2% 3.3%
Resistance to four drugs 2 2% 3.3 %
INH Resistance 14 28% 46.6%
Rates of Primary MDR are generally low; median 1.4%
Secondary MDR TB much more common median 13.0%
Highest proportion
Latvia 54%
South Korea 28%
Russia 27.7%

Predisposing Factors:
• Type of bacterial Population
• Insufficient Concentration of Drug
• Patients Drug inactivation status

Patient Factors:
• Contact with resistant case
• Irregular drug intake
• Premature drug stoppage
• Poor absorption (Intestinal TB Excessive vomiting).
• Economic reasons.

Disease Factors:
• In Cavitatory TB
• Drug concentration fluctuates
• Higher no. of bacteria.
• PH Factor
• Thickened Pleura
• Barrier to effective drug penetration

Iatrogenic Factors:
• Treatment with one effective drug
• Inadequate dosage
• Inadequate duration
• Use of cross resistant drugs

Inadequate Prescribing Practice:
• In 1995 25% of new cases of TB were initially treated with 2-3 drugs regimen
• 2 Surveys by AKUH among GP & Interns
• Once resistance develops, prescribing errors, usually by inexperienced physicians can exacerbate situation.
• Review of patients referred to National Jewish Hospital (Denver) for management of complex MDR-TB documented an average of 3.93 prescribing errors per patient.

Erratic Compliance:
• New York study by Brudrey showed that out of 178 patient only 11 % compliant
• Drug often taken erratically and often singly

Nosocomial Transmission:
• In Prisons
• In Hospitals
• In Nursing Homes

HIV Infection is often associated with a high prevalence of drug resistance
• Patient fails to improve
• Patient improves initially but has recurrence of symptoms
• Patient fails to become smear negative
• Patients who have taken treatment previously
• Previously treated patients who have been non compliant.

Implication Of MDR:
• Prolonged hospital stay & Isolation
• Loss of benefit of short course chemotherapy
• High cost of treatment
• Low success rate
• High relapse rate

Diagnosis:
• Once suspected it is easy to diagnose
• Diagnosis follows same lines as standard TB
• AFB culture and sensitivity should be sent

Treatment:
General Principles
• Isolation to prevent spread of disease prolonged hospital admission.
• D.O.T with effective drugs.
• If already taking treatment add at least two new drugs.
• Adjust treatment according to sensitivities when available.

Treatment:
General Principles
• Never add one drug at a time.
• Treatment to be continued for longer period (12-24 months)
• INH is often useful even if the sensitivities don’t favour it.

Isoniazid Monoresistance:
• Rifamycin, Pyrazinamide and Ethambutol for 6 to 9 months or 4 months after culture conversion.

Rifampicin Monorisestancae:
• Most often seen in HIV positive patients.
• Uncommon but increasingly frequent.
• Because Rifampicin is corner stone of all six months regime, resistance requires prolongation of treatment.

Streptomycin, Isoniazid, Pyrazinamide for 9 months. (12 months for HIV +ve)
• SHE for 3 months followed by HE for 18 months.

Pyrazinamide Monoresistance“
• Requires 9 months of Isoniazid and Rifampicin.

Monoresistance To Other Agents:
• Single drug resistance to Ethambutol, Streptomycin, or second line agents is of little clinical significance.
• Patient can still be treated with 2 RHZ followed by 4 to 6 months of RH.
Suggested Treatment regimens for multidrug resistant tuberculosis
Suggested Treatment regimens for multidrug resistant tuberculosis

Prevention Of MDR:
• Educate the prescriber.
• Educate the patient.
• DOTS
• Availability of drugs.
• Using 4 drugs in initial phase, 3 in continuation & giving treatment for 9 months.
• More frequent use of Microbiology services.
• Drug levels.
• Reference Lab.

………………………………………………………………………………………………………

Details about tuberculosis treatment - By: Groshan Fabiola



The treatment of tuberculosis lasts a long period of time, from six to nine months but it gives remarkably good results in patients. Only in some cases drugs are not bared by the patient and side effects appear. In order to prevent them from happening the doctor monitorizes closely the evolution of the patient by performing blood, urine tests and thoracic x-rays.

The doctor must be announced when nausea, vomiting, fever and jaundice appear. Some patients might develop a skin rash and bruises from the drugs, others might feel numbness in hands or feet and others might have visual problems. The doctor needs to be informed if these kinds of situations appear because he will change the treatment and will replace the harmful drugs with others suitable for the patient.

In the process of treating tuberculosis, doctors use certain drugs that might give certain side effects. For example, Isoniazid can be responsible for the loss of appetite, for nausea, and for tingling in the hands and feet. Rifampicin can interfere with contraceptive pills treatment reducing their effect and can also stain the contact lenses of the patient. Ethambutol is known to cause visual problems so if you follow such a treatment you will periodically be checked by an ophthalmologist to determine whether you can continue the treatment with Ethambutol or not. Pyrazinamide can cause a loss of appetite, nausea, skin rashes and intense itching. Generally Pyrazinamide is recommended only in the first two months of treatment but make sure you inform the doctor if any of these symptoms occur to you.

If the patient takes other medication he must report this thing to the doctor because some pills might interfere with the anti-tuberculosis treatment and others might not be effective if they get in contact with the anti-tuberculosis pills.

The treatment must be followed as prescribed and taken for the period of time the doctor tells you so. Even if the patient feels better the treatment must be continued until the six months have passed because the germs that have cause tuberculosis are not killed until the treatment is done and they might continue to infect the patient and the people who come in close contact with the patient. Also, by taking the pills irregularly, the drug resistance might install and the doctor will have to change the treatment in order to make it effective again but the options are not numerous and the doctor will not have any more separate drugs to replace the others in a short while.

It is important for the patient not to drink any alcohol during the treatment as it can interfere with the drugs and cause toxicity, affecting the liver.


………………………………………………………………………………………………

What should you know about Tuberculosis? - By: Groshan Fabiola


Tuberculosis is a germ infection caused by Mycobacterium tuberculosis which generally affects the lungs, but it can also affect kidneys, lymph nodes, spine, intestinal tract and brain.

Tuberculosis is spreading by air, if an infected person coughs sneezes or shouts, the germs spreading into the air. By inhaling them other people get infected.

At the thoracic X-ray appear granulomas (granular tumors) in the lungs.

Most people’s immune system contains the primary infection, but some do not have this particularity, and so, the disease may occur within weeks after the primary infection.
Some people shed the TB germ into their lungs for years and at some moment the germs could activate and the infection could manifest.

The easiest to infect are the children and people who have a weakened immune system (those undergoing chemotherapy, those who had an organ transplant and now take immunosuppressive drugs, and those infected with HIV).

To prevent TB in children doctors give them shots of the bacillus Calmette Guerin (BCG) vaccine.

The risk of catching TB increases with the frequency of contacting other infected people, with miserable living conditions and with poor nutrition.

Lately there has been noticed an increase of TB cases in US, probably because of the increased number of people infected with HIV, the increased number of homeless people and of the appearance of drug resistance (caused by an incomplete TB treatment).

In US there are 10 cases of TB per 100000 people and those infected with AIDS are among them, due to their weakened immune system.

Some of the TB symptoms are cough for a long period of time, fever, night sweats, loss of weight and appetite, chest pains and breathing difficulties.

To diagnose the infection with TB there are some tests to be done.
One way to diagnose TB is by performing a skin test called the intra-dermal reaction of tuberculin. The person that is suspected to be or to have been infected with TB is considered to have developed a hypersensitivity to the TB germ.

The test consists in injecting into the skin a purified protein derived from the TB germ. After more then 48 hours the skin area will present a bump. If the bump is large, the test is considered to be positive, meaning that the TB infection has occurred.

Even if the test is negative, it should be repeated after a while, because the test is not a 100 percent accurate.

Another method of diagnosing TB is performing a thoracic X-ray that will show the affected lung areas.

And last, but not the least, is the sputum test. If the suspected person coughs, doctors take the sputum and with the help of the microscope they search for the TB germs in it.

Also doctors can perform a Bronchoscopy, a Thoracocentesis and rarely, biopsy of the affected tissue.

For the treatment to be effective, patients must take their prescribed dugs during all the period of time they were advised by the doctor, otherwise they could get multiple organ complications and even die.

By following all the doctor’s indications, one can cure in about 6 to 9 months of TB and get back to its normal life.


………………………………………………………………………………………………

The sanatoriums method in dealing Tuberculosis - By: Groshan Fabiola


The age of Tuberculosis sanatoria began in 1849 when public health tried to isolate the sick persons from the healthy population. The fact that Tuberculosis is actually a contagious disease and can be transmitted from man to man was not yet known.

The idea of Tuberculosis being a curable disease and not a death sentence was first expressed by doctor Brehmer in 1854 after he suffered from the disease himself. As a student he caught Tuberculosis and was sent by his doctor to change the climate and live a healthy life in the Himalaya Mountains. He returned home cured and wrote a debate about how Tuberculosis can be cured.

Brehmer built a sanatorium for his tuberculous patients where they could get dietary food, fresh air, sun shines and a high elevated life.

The Tuberculosis suffering Doctor Trudeau opened the most famous sanatorium in America, Saranac Lake, where he also conducted laboratory testing and investigation concerning the cure of Tuberculosis. Patients in his sanatorium were strictly supervised, had to stay in bed the whole first three months to rest, eat healthy and drink high amounts of milk. Trudeau continued Koch’s studies of identifying the structure and physiology of Mycobacterium in order to understand how it could be killed.

All sanatoriums burned and disposed all the objects of the new income as it was proven the bacteria can for a period of time survive inside the clothes tissues, until it found a new host.

The sanatorium cure spread into entire Europe and America; it provided a dual action against Tuberculosis. Isolation of active cases from the healthy population made it possible to control the spreading of the disease. Secondly, sanatoriums provided the patients with regulate, hospital medical care and a better social and cultural environment.

Frequently, people were brought and interned in sanatorium against their will. Many persons could not understand the benefic consequences of this kind of cure, or even felt depressed. In an age without any sort of chemical medication the self-control, autosuggestion and a good moral played a tremendous role in the healing process.

The era of sanatoriums was over when the first antibiotic against Tuberculosis was discovered. Streptomycin successfully treated the infection and enabled patients to be treated in hospitals or receive home treatment. In order to prevent the development of resistance to antibiotics, a combination of efficient drugs is used in the medication lasting normally at least 6 months, even a whole year.

…………………………………………………………………………………….

Tuberculosis (TB) Part I - By: Dr. D.S. Merchant


Background: Tuberculosis (TB) is the number one infections disease killer worldwide. The World Health Care Organization estimates that 2 billion people have latent TB, while another 3 million people worldwide die each year due to TB.

On average, the isoniazid (INH) resistance rate is approximately 10% and the rifampin resistance rate is approximately 1%, with lower numbers in countries with good TB programs and higher numbers in the countries with poor TB programs.

Pathophysiology: Humans are the only known reservoir for Mycobacterium tuberculosis. TB is transmitted by airborne droplet nuclei, which may contain fewer than 10 bacilli. Exposure to TB occurs by sharing common airspace with a patient who is infectious. When inhaled, droplet nuclei are deposited within the terminal airspaces of the lung. Upon encountering the bacilli, macrophages ingest and transport the bacteria to regional lymph nodes.

The bacilli have 4 potential fates:
1. They may be killed by the immune system.
2. They may multiply and cause primary TB.
3. They may become dormant and remain asymptomatic, or
4. They may proliferate after a latency period (reactivation disease). Reactivation disease may
occur following either 2. or 3. above.

Frequency:

In The US: Beginning in 1985, a resurgence of TB was noted. The increase was observed primarily in ethnic minorities and especially in persons infected with HIV. TB control programs were revamped and strengthened across the United States. After peaking at 25,287 (1993), the number of reported cases began to fall again. In 2001, 15,989 cases of TB were reported to the US Centers for Disease Control and Prevention (CDC). An estimated 10-15 million people have latent infection. Among foreign immigrants, 74% of cases reported in 1998 were related to 7 countries:
1. Vietnam
2. Philippines
3. India
4. China
5. South Korea
6. Mexico
7. Haiti
Foreign born persons account for a steadily increasing proportion of all reported TB cases.

Internationally: An estimated 20-33% of the world’s population is infected with M tuberculosis. Countries with the highest prevalence include Russia, India, Bangladesh, Pakistan, Pakistan, Indonesia, Philippines, Vietnam, Korea, China, Tibet, Hong Kong, Egypt, most Sub Saharan African countries, Brazil, Mexico, Bolivia, Peru, Colombia, Dominican Republic, Ecuador, Puerto Rico, El Salvador, Nicaragua, Haiti, Honduras, and areas undergoing civil war (e.g. Balkan Countries). Countries in Eastern Europe have an intermediate prevalence. Costa Rica, western and northern Europe, the United States, Canada, Israel, and most countries in the Caribbean have the lowest prevalence.

Mortality / Morbidity: The case fatality rate for TB was 50% for untreated patients before the advent of antibiotic therapy. Deaths worldwide are are estimated at 3 million per year. In United States, the mortality rate dropped from 12.4 deaths per 100,000 population (1953) to 0.6 deaths per 100,000 population (1993); this is approximately 7% per newly identified case.

Multidrug resistant during tuberculosis (MDR-TB) cases have a higher reported mortality rate. Patients with underlying diseases predisposing to active TB also have higher morality rates.
Morality of untreated congenital TB is 50%.
TB can mimic congenital syphilis or cytomegalovirus (CMV) infection.

Race: Based on 1990 CDC data, case rates were 10 times higher for Asians and Pacific Islanders; 8 times higher for non Hispanic blacks; and 5 times higher for Hispanics, Native Americans, and Native Alaskans, as compared to non Hispanic whites. However, race may not be an independent risk factor. Risk is best defined on the basis of social, economic, and medical factors.

Sex: Despite the fact that TB rates have declined in both sexes in the United States, certain differences exist. TB rates in women decline with age; in men, they increase with age. Men are more likely to have a positive tuberculin skin test. The reason for these differences may be social rather than biological in nature.

Age: In the 1997 CDC data for the United States, more than 60% of cases occurred in persons aged 25-64 years. The age specific risk was highest in persons older than 65 years. Infection in infants and young children (up to 5years) always indicates recent transmission. If left untreated, it may result in life threatening meningitis or disseminated disease, Elderly patients may not have typical signs and symptoms of infection because they may not mount a good immune response. In elderly patients, an active tuberculosis infection may present as an non resolving pneumonitis.