Tuberculosis

[ScreamingEagle]

Working at their own risk

By LINN E. CAROLEO
Apr 27, 2005

Farm workers often labor in fields sprayed with potentially harmful pesticides.

But that may be the least of their worries, says a Yuma physician who has cared for them.

"Things that one may expect migrant workers to suffer from, like sunstroke or pesticide poisoning, happens a lot less than one would think," said Dr. Steven Anderson. "I used to see more musculoskeletal injuries, like back pain, because what they do is really back-breaking work. And there were also some acute injuries, like people cutting themselves with lettuce knives and such.

"Really, the more serious issue is that there are higher incidents of tuberculosis in this population and that spills over into the Yuma health system," he added.

The Center for Disease Control says the risk for tuberculosis among migrant workers is estimated as being six times greater than in the average U.S. population.

"People who share the same air with an infectious person for long periods of time are at risk of becoming infected. This includes persons living in the same household with the infectious person and those who travel in the same vehicle," said Anderson.

http://sun.yumasun.com/artman/publish/articles/story_16283.php

 

[waltky]

Granny says its one o' dem end time plagues in Revelation inna Bible...

IRC Says 10 Million Might Die of Tuberculosis by 2015
March 25, 2011 - The International Federation of Red Cross and Red Crescent Societies warned Thursday that as many as 10 million people will die of Tuberculosis by 2015, unless the international community intervenes. The world's largest humanitarian and development network presented its report to mark World Tuberculosis Day.

Tuberculosis - preventable and curable

The International Federation of Red Cross and Red Crescent Societies (IFRC) says worldwide access to affordable, effective treatment and care is crucial to halt a global and often deadly Tuberculosis pandemic. In its latest report, "Towards a Tuberculosis-Free World," the IFRC warns that by 2015 more than 10 million people could die from an illness that experts say is preventable and curable. The report says that more than 80 percent of tuberculosis cases occur in Africa and Asia, with India and China alone accounting for a third of people suffering from the disease.

Challenges: multi-drug resistance, cost

Dr. Sonja Tanevska, Heath and Care Coordinator of the IFRC Europe Zone, says there is also concern about Eastern Europe and the Central Asian nations of the former Soviet Union. "Eastern Europe is unfortunately affected by the form of tuberculosis that is very difficult to treat. It is multi-drug resistant tuberculosis,” Dr. Tanevska said. “This is why Eastern Europe is very specific and it is very important for [the] fight [against] Tuberculosis." Dr. Tanevska says part of the problem is that many people diagnosed with tuberculosis in these former Communist nations do not complete their treatment because of the cost, which can range from $100 to $7,500. Dr. Tanevska says that each year, hundreds of thousands of people in Eastern Europe and Central Asia are infected with tuberculosis and that seven people in the region die of the illness every hour.

Yet, she explains, IFRC volunteers have been able to save the lives of thousands. "Our report has a story from Turkmenistan. One of our volunteers in our program, she had tuberculosis twice in her life -- once when she was a child and she was cured and a second time she got tuberculosis when she was 33 [years old]. She was devastated,” she explains. “And only Red Cross Red Crescent volunteers helped her to go through this difficult period. And they gave her psychological support and in many ways helped the family in general to go through this difficult period. And she is now one of the volunteers of Turkmenistan Red Crescent.”

Future needs

 

[JBeukema]

In other news: Water wet according to scientists

 

[old navy]

It's the Center(s) for Disease Control.

 

[waltky]

Prob'ly will work - until the germs get resistant to it...

Combination Pill Found Effective Against TB
April 15, 2011 : 4-in-1 tablet could reduce drug-resistance

A new study finds that combining four tuberculosis drugs into one pill could help fight drug-resistant strains of the disease. One of the main reasons those strains develop is because many TB patients don't take their medicines as instructed. The World Health Organization's recommended treatment for tuberculosis includes four drugs. Combined in one pill, they are easier to take. But there have been doubts about whether the four-in-one pill is as effective.

In this new research, WHO scientist Christian Lienhardt and colleagues studied how patients responded to the combination pill compared with the drugs in separate pills. TB patients were recruited in 11 countries in Latin America, Africa, and Asia, and divided into two groups. One got the combination pill, the other took the same drugs in individual pills.

Lienhardt's team used three different methods to measure whether different ways of taking the drugs were equally effective. The found the combination pill was slightly less effective. But that might be more than compensated for by the assurance that the patient taking the combination pill is getting all the medicine, not a partial dose that could kill the weaker strains while allowing the more drug-resistant TB bugs to survive. "It's important to be able to fight and prevent multi-drug resistance, which is really an emerging, and a very high concern for people who take care in the fight against tuberculosis," says Lienhardt. "And the best way to prevent resistance is to make sure that treatment is fully being taken."

The combination pills are already being used in some TB treatment programs, but other programs have avoided them because of concerns about their effectiveness compared with individual pills. The study was funded by the U.S. Agency for International Development (USAID) which, the authors say, had no role in the conduct of the study or its conclusions. The paper by Christian Lienhardt of the World Health Organization and his colleagues is published in the Journal of the American Medical Association, JAMA.

Source

 

[jesereL]

They must be well educated about health risk factors.

 

[editec]

Piblic heath is one of those issues to suggest to most of us that having a government is a pretty damned good idea.

And yes, it also means that we do not have unlimited freedoms, too, which is vexing, I'll admit.

And so I present for your consideration the story of TYPHOID MARY

Mary Mallon (September 23, 1869 – November 11, 1938), also known as Typhoid Mary, was the first person in the United States identified as a healthy carrier of the pathogen associated with typhoid fever. She was presumed to have infected some 53 people, three of whom died, over the course of her career as a cook.[1] She was forcibly quarantined twice by public health authorities, and died after nearly three decades altogether in quarantine.

Eventually, the New York State Commissioner of Health, Eugene H. Porter, M.D., decided that disease carriers would no longer be held in isolation. Mallon could be freed if she agreed to abandon working as a cook and to take reasonable steps to prevent transmitting typhoid to others. On February 19, 1910, Mallon agreed that she "[was] prepared to change her occupation (that of cook), and would give assurance by affidavit that she would upon her release take such hygienic precautions as would protect those with whom she came in contact, from infection". She was released from quarantine and returned to the mainland.[4]
She had been given a job as a laundress, which paid lower wages, however. Mallon adopted the pseudonym Mary Brown, returned to her previous occupation, and in 1915 was believed to have infected 25 people, resulting in one death, while working as a cook at New York's Sloane Hospital for Women. Public-health authorities again found and arrested Mallon, returned to quarantine on the island on March 27, 1915.[4] Mallon was confined there for the remainder of her life. She became something of a minor celebrity, and was interviewed by journalists, forbidden to accept even a glass of water from her. Later, she was allowed to work as a technician in the island's laboratory.

My goodness the oppressive NANNY STATE violated her civil rights!

Now the question for libertarians is this:

Does society have the right to defend itself from people like Typhoid Mary?

I think it does.

Do any of you think me a collectivist, socialist, commie, pinko, liberal for thinking that it does?

 

[waltky]

Immigrants bringin' in TB...

TB screening 'missing most cases'
20 April 2011 - Current screening for TB in immigrants arriving in the UK is missing the majority of cases, say researchers.

Using new blood tests for checks would be better than chest X-rays, which detect only active infections, says an Imperial College London team which analysed more than 1,000 immigrants. Blood tests could prevent substantial numbers of cases, they write in The Lancet Infectious Diseases. The government said the research backed new guidance from health watchdog NICE.

Tuberculosis is caused by a bacterial infection, which attacks the lungs. It has risen dramatically in the UK over the past decade, partly because of an increase in cases among people who move to the country from overseas. Immigrants arriving in the UK from countries with a high incidence of TB are required to have a chest X-ray on arrival to check for TB. But this screening method can miss cases where the infection lies dormant in the lungs and does not cause symptoms.

Professor Ajit Lalvani, of Imperial College London, argues that new blood tests should be used to pick-up cases where people are carrying TB infection but will not develop it for several years. His research is based on an analysis of more than 1,000 immigrants at centres in London, Leeds and Blackburn.

He said: "By treating people at that early stage, we can prevent them from developing a serious illness and becoming infectious. "Crucially, this wider screening could substantially reduce TB incidence while remaining cost-effective. Our findings provide the missing evidence-base for the new national strategy to expand immigrant screening." NICE updated its guidelines on TB screening in March.

Latent infections

 

[waltky]

New combo to treat DR-TB...

Effectiveness of Four-Drug TB Treatment Confirmed
April 25, 2011 - One of the biggest challenges in fighting tuberculosis comes from new drug-resistant strains of the disease. And one of the main reason those strains have developed is that TB patients often don't take their standard, 14-pill, course of medication as instructed. Now, as Vidushi Sinha reports, a new study finds that a simpler approach - combining four TB drugs into one pill - is just as effective in treating this global killer.

For about a decade now the World Health Organization has recommended treating tuberculosis by using a four-drug, fixed-dose combination of medication - which has the same amount of pharmaceutical ingredients as the 14 pills that have traditionally been used. But the logic of fewer pills - a simpler routine for sick patients - has not yet sunk in among many doctors. For a variety of reasons, health professionals treating TB have resisted prescribing fewer pills.

But a new study in the high-TB-incidence areas of Africa, Asia, and Latin America confirms that the four-drug combination of pills is just as effective as the 14-pill regimen. Dr. Christian Lienhardt conducted the the research in several countries comparing the new and old treatment regimens. "It is true everywhere in the world patients, don’t like to take too many pills and if you have to take 14 pills every day for 6 months - you have the choice for four, then I will prefer 4 and lot of people will prefer 4," said Dr. Lienhardt.

But Lienhardt says the four-pill treatment has been resisted because many care providers intuitively doubt it would be as effective. "There is a type of a common sense and mainly among the health staff that when you take the older drugs that you know each one of them had a very, very good activity and when you combine maybe there is a way to lose that activity," he said. "That is a type of common sense that might unfortunately take place mainly among the care providers rather than the patients."

MORE

 

[editec]

Piblic heath is one of those issues to suggest to most of us that having a government is a pretty damned good idea.

And yes, it also means that we do not have unlimited freedoms, too, which is vexing, I'll admit.

And so I present for your consideration the story of TYPHOID MARY

Mary Mallon (September 23, 1869 – November 11, 1938), also known as Typhoid Mary, was the first person in the United States identified as a healthy carrier of the pathogen associated with typhoid fever. She was presumed to have infected some 53 people, three of whom died, over the course of her career as a cook.[1] She was forcibly quarantined twice by public health authorities, and died after nearly three decades altogether in quarantine.

Eventually, the New York State Commissioner of Health, Eugene H. Porter, M.D., decided that disease carriers would no longer be held in isolation. Mallon could be freed if she agreed to abandon working as a cook and to take reasonable steps to prevent transmitting typhoid to others. On February 19, 1910, Mallon agreed that she "[was] prepared to change her occupation (that of cook), and would give assurance by affidavit that she would upon her release take such hygienic precautions as would protect those with whom she came in contact, from infection". She was released from quarantine and returned to the mainland.[4]
She had been given a job as a laundress, which paid lower wages, however. Mallon adopted the pseudonym Mary Brown, returned to her previous occupation, and in 1915 was believed to have infected 25 people, resulting in one death, while working as a cook at New York's Sloane Hospital for Women. Public-health authorities again found and arrested Mallon, returned to quarantine on the island on March 27, 1915.[4] Mallon was confined there for the remainder of her life. She became something of a minor celebrity, and was interviewed by journalists, forbidden to accept even a glass of water from her. Later, she was allowed to work as a technician in the island's laboratory.

My goodness the oppressive NANNY STATE violated her civil rights!

Now the question for libertarians is this:

Does society have the right to defend itself from people like Typhoid Mary?

I think it does.

Do any of you think me a collectivist, socialist, commie, pinko, liberal for thinking that it does?

Hmmmm...not a single FREE MARKETEERING, self proclaiming lover of freedom, hater of the NANNY STATE even willing to discuss this, eh?

Not surprising, really.

 

[peterleishman]

Tuberculosis is causes by micro bacteria and generally it was seen in Lungs in human being. It was infectious disease that a person that TB and another person leaving with it and drink patient water and all. So another person also get this disease.

 

[waltky]

Chronic disease becoming leading killer...

UN: Chronic, Non-Communicable Disease Is World's Leading Killer
May 09, 2011 : Chronic, non-communicable diseases such as cancer, heart disease, stroke, and diabetes are on the rise and are taking a significant toll on the economies of low- and middle-income countries. This is according to a new report from the World Health Organization.

The WHO's first Global Status Report on what it calls "the leading killer today" says that in 2008, more than 63 percent of those who died worldwide - more than 36 million people - were killed by non-communicable diseases. And it says 80 percent of those deaths were reported in developing countries. The WHO says contagious afflictions - such as HIV/AIDS and tuberculosis - are not the ones that pose the greatest global threat to public health. Instead, it says, the major threat comes from non-communicable diseases, or NCDs - which are often the result of poor diet and lifestyle choices, environmental influence or genetics.

In many parts of the world, the numbers of NCD cases are soaring, and abuse of tobacco and alcohol have only compounded the problem. The WHO says the billions of dollars being spent, year after year - on treating chronic illnesses such as cancer, heart disease and diabetes - are pushing millions of people in the developing world below the poverty line. Margaret Chan, WHO's director-general, said greater attention must be paid to the link between these killer diseases and the economic well-being of low- and middle-income countries.

"For some countries it is no exaggeration to describe the situation as an impending disaster," said Chan. "I mean a disaster for health, society and national economies. The challenge of combating non communicable diseases has some unprecedented dimensions." Experts say changing demographics are at the root of the NCD problem. In many developing countries, the populations are growing quickly, ageing and also adopting more urban lifestyles.

Dr. James Hospedales, an expert on chronic diseases, said the problem of NCDs is much more widespread than many people realize. He said they are a major problem in big countries like the United States, India, China, and in nations across Latin America and the Mediterranean region. While infectious diseases get most of the attention in Africa, the WHO estimates that chronic diseases will surpass them as the leading cause of death in many African nations by 2020.

MORE

 

[Dabs]

My Mother had TB, and she had it when she delivered me.
After I was born, she had to spend one year in a TB hospital- I was so young so I don't remember any of that at all, but I recall my Mother talking about it.
And then other family members telling me how sad my Mother was because she couldn't be with me for the first year of my life.
Then, for a good many years after she was back home, she and I both had to be tested quite often.

 

[waltky]

TB may someday be a thing of the past...

New simpler TB treatment may help stop spread
5/16/2011 - Simpler drug combo requires just 12 doses over 3 months, instead of yearlong therapy

U.S. health officials say they have found a far simpler therapy for people at risk of developing tuberculosis, addressing a key barrier to preventing the spread of the disease. Patients who took a combination of two drugs just 12 times over three months fared as well as those who received the standard treatment that requires 270 daily doses, according to a landmark U.S. government study released Monday.

"New, simpler ways to prevent TB disease are urgently needed, and this breakthrough represents one of the biggest developments in TB treatment in decades," Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, said in a statement. The far less onerous regimen involves taking rifapentine, an antibiotic sold by French drugmaker Sanofi under the brand name Priftin, along with isoniazid, an effective tuberculosis drug in use since the 1950s.

The study results, presented at a medical meeting on Monday, could mark a major advance in preventing TB in countries with low-to-medium incidence of the highly infectious disease, according to the CDC, which sponsored the study. While many people believe TB to be a largely conquered disease of the past, there were more than 11,000 cases reported in the United States last year, and it remains one of the world's leading infectious killers, according to the CDC.

The 10-year study included more than 8,000 patients with latent TB infection, meaning they have the tuberculosis bacteria in their bodies but no symptoms and are not contagious. More than 11 million Americans are positive for latent TB, the CDC said, with Asians, other minorities and foreign-born individuals disproportionately affected.

More New TB treatment may help stop spread - Health - Infectious diseases - msnbc.com

 

[syrenn]

TB is not the only disease that is on the upswing do to unvaccinated people. Pertussis, whopping cough is another one on the up swing.

 

[Sunni Man]

TB is not the only disease that is on the upswing do to unvaccinated people. Pertussis, whopping cough is another one on the up swing.

When my granddaughter was born.

I was around her for approximately 3 months.

So the doctor told my daughter to have me come in and take a shot to prevent it

 

[waltky]

Getting treatment to those who need it...

New Procedure Could Get More TB Patients Treated
July 15, 2011 - Study experiments with more convenient disease testing schedule

An international team of researchers has found that revised protocols for diagnosing tuberculosis may be more user-friendly for patients and help bring more people into treatment, especially in poorer countries. In many places around the world where tuberculosis is a major threat, suspected cases are diagnosed by looking through a microscope for the TB bacteria in sputum - the mixture of saliva and mucus that the patient coughs up.

Under current protocol, three specimens are collected on two consecutive days - one "on-the-spot" in the clinic, one the next morning at home, and then a third "spot" sample when the patient returns to the clinic. But many patients don't live near a diagnosis facility, so often they come once, but don't return for the next day's tests. Luis Cuevas of the World Health Organization and the University of Liverpool in England and colleagues tested a variation of the protocol, taking two "spot" samples in the clinic an hour apart, and a third one the next day.

"And if you use the new scheme, you end up with exactly the same result. Whether you do it one way or another, you end up with the same number of cases." Not only that, the results from examining just the first two specimens identified most TB-positive patients. So if both specimens are collected on day one, there is a greater likelihood of an accurate diagnosis. The studies were done in Ethiopia, Nepal, Nigeria, and Yemen.

Researcher Cuevas says it's important to improve the process of diagnosing tuberculosis. "What we see very frequently is that accessing the diagnosis for TB is often a barrier to access treatment for TB. So, facilitating a rapid diagnosis is very key to improve access to treatment." There are more high-tech diagnostic tests for tuberculosis, but they are as much as 15 times more expensive than microscopic examination of the sputum, so in resource-poor countries the less costly diagnosis procedure is likely to remain dominant.

New Procedure Could Get More TB Patients Treated | Health | English

 

[waltky]

Halt called on TB blood tests...

World Health Organization calls for TB blood test ban
21 July 2011 - TB can lie dormant for years

Blood tests designed to detect active TB are inaccurate and should be banned, the World Health Organization has said. More than two million such tests are carried out annually, but the WHO says they are unethical and lead to misdiagnosis and the mistreatment of patients. The organisation's review of these tuberculosis test kits says they give wrong results in around 50% of cases. The kits are mainly sold in the developing world.

However, most of the 18 kits on the market are produced in Europe and North America. According to Dr Mario Raviglone, the director of the WHO Stop TB Department, the tests must be banned. He said: "A blood test for diagnosing active TB disease is bad practice. Tests are inconsistent, imprecise and put patients' lives in danger."

The tests work by detecting antibodies or antigens in the blood that are produced in response to the bacterium. But some of these commercial tests have what's called "low sensitivity" which leads to large numbers of patients being told they do not have TB when they do.

'Unethical'

Dr Karen Weyer, who is also from the WHO Stop TB department, added: "The evidence we reviewed over the past couple of months shows that one in two patients will be wrongly diagnosed, either [as] false negative or false positive. "If it's a false negative patients get the all clear when they in fact have TB, the disease continues to spread, and the patients may die.

More BBC News - World Health Organization calls for TB blood test ban

 

[waltky]

TB drug can shorten treatment period...

New Treatment Potential Found in Popular TB Drug
August 19, 2011 - Scientists say new insights into a common tuberculosis drug will make it possible to shorten the treatment period for patients infected with TB.

The drug "pyrazinamide" is widely used in combination with other drugs to treat active tuberculosis infections. Now, doctors are learning more about how it works - and calling the new information a "breakthrough." The standard therapy for treating active tuberculosis infections today is to give patients a combination of four drugs, taken over a period of six months. Forty years ago, TB treatment took much longer - until what experts call the "breakthrough drug" came along.

Dr Clifton Barry, who directs tuberculosis research at the National Institutes of Health, said, “Pyrazinamide allowed that period to be shortened to six months - compared to two years. It was dramatic breakthrough in the 1970s.” He said scientists have long known that pyrazinamide, by itself, does not destroy the active TB bacterium. But research has now revealed that the drug does kill the latent form of the microbe, which does not cause observable symptoms. With their improved understanding of how pyrazinamide actually works at the molecular level, Barry said scientists will be able to design a more potent form of the drug that could shorten the duration of TB treatment from six months to just two.

“Before, it was a completely empirical approach: Just try anything you can and see if that kills the bacteria a little more quickly or under certain non-replicating conditions. Now, with [our knowledge of the drug's] molecular mechanism, all of a sudden we can use all the tools of modern drug discovery, which means structure-based, protein-targeted approaches,” said Barry. Dr. Barry believes this new, more targeted use of pyrazinamide could finally break the back of the global TB epidemic, which has infected nearly one third of the world’s population. While more than 8 million people are sick with the highly contagious active form of TB, an estimated two billion people carry the latent form - with no symptoms.

“Remember that every case that develops into active disease spreads it to at least 10 more people. And so instead of treating those 10 people, if we start to treat the people before they get sick - who are asymptomatic - then we can really make a huge difference in how many people get sick with the disease." Experts are applauding the new insights into this important TB drug, and the prospects for improved therapies. But they say the best way to slow the global tuberculosis epidemic is to match these treatment gains with similar strides toward faster, more reliable TB testing.

Source

 

[waltky]

TB cousin could be used as vaccine...

Tuberculosis relative could be new vaccine
4 September 2011 - Injecting modified bacteria related to those which cause tuberculosis could protect against the lung disease, US scientists say.

Experiments on mice showed the injections could completely eliminate tuberculosis bacteria in some cases, Nature Medicine reports. The only TB vaccine - the BCG jab - is not very effective. The research is in its early stages and the potential for a human vaccine is unknown, campaign group TB Alert says. Tuberculosis is caused by Mycobacterium tuberculosis. It is one of the top 10 leading causes of death, according to the World Health Organization, killing 1.7 million people each year. The BCG vaccine has variable results. It has been shown to be between 0% and 80% effective in different parts of the world. There are also potential problems giving the live vaccine to some of the most at risk patients - those with HIV.

In the family

Researchers at the Albert Einstein College of Medicine in New York were investigating a cluster of genes called esx-3, variants of which are in all types of Mycobacterium and help the organisms evade the immune system. Mycobacterium tuberculosis cannot survive without its esx-3 genes but its relative, Mycobacterium smegmatis, can. Scientists deleted the genes from M. smegmatis and injected an otherwise deadly dose into mice. Within three days the mice had cleared the bacteria from the lungs and kidneys. The research team then tried putting the esx-3 genes from M. tuberculosis into M. smegmatis, which they then called Ikeplus. Mice were still able to rapidly clear an Ikeplus infection but it seemed to leave a lasting immunity against M. tuberculosis.

Survival

In mice infected with the TB bacteria, those which received no vaccine died after 54 days on average. Those vaccinated with BCG lasted 65 days, while mice immunised with Ikeplus survived for 135 days. In the mice which survived the longest, more than 200 days, researchers were no longer able to detect the deadly bacteria. Lead researcher Prof William Jacobs said: "We consistently protected mice better with Ikeplus than with BCG.

"This is something we've dreamed about for years, to be able to get longer protection and bactericidal immunity." He warned that only 20% of the mice were long-term survivors so the vaccine would need further development. He added: "Ikeplus is different from any other TB vaccine and it's a new tool for the TB arsenal." A TB Alert spokesperson said: "These are interesting experiments but it is too early to tell what impact they will have on the development of a safe and effective vaccine."

BBC News - Tuberculosis relative could be new vaccine