Tuberculosis is an ancient killer, and is one of the few diseases that has been traced back to Ancient Egypt and beyond. TB has ravaged humanity for millennia, and was commonly called consumption due to its tendency to produce weight loss.

Once thought to be under control, TB has received a new lease on life with the emergence of AIDS. All countries except North America, western Europe, and Australia have a problem with tuberculosis, which kills more than 1 million people each year.

The tuberculosis germ is unusual in that It has a cell wall high in the lipid, mycolic acid. This protects the germ when it is engulfed by first responders such as macrophages. The infected cell Is surrounded by other macrophages, lymphocytes and Fibroblasts to form a granuloma. This creates a standoff, where the tuberculosis germ is still alive, but walled off, and becomes an inactive or “latent” case of tuberculosis, a small percentage of which become active each year.

Active tuberculosis produces the usual infectious symptoms of fever, chills, and cough, often productive with blood. The tuberculosis germ multipliesu much more slowly than most other bacteria and the symptoms are long and drawn out; a cough lasting for more than a month, especially if accompanied by weight loss, should raise the suspicion of TB.

TB can spread to infect bones, kidneys, liver, and brain,  but prefers the lung.

A spot on the Lung, confirmed by a Tuberculin test, or a blood test called a T-spot, will confirm the diagnosis.

The slow multipication of the tuberculosis Germ requires much longer treatment, and the combination with AIDS has caused a  rapid development of resistant organisms. Fortunately, there are several drugs available.

Only one immunization is currently available, namely BCG. This has been used a lot in Europe and other countries . BCG produces a weekly positive tuberculin test.

A large number of conditions which reduce immunity, such as cigarette smoking, drug use, and immunosuppressive treatments associated with organ transplants and cancer will  predispose a person to catching tuberculosis. TV is transmitted in the tiny droplets from sneezing, coughing, or talking such as we were accustomed to thinking about during Covid. The same preventative measures, such as  masks and avoiding close contact with infected individuals should be practiced to prevent spread from an infected person.

If you follow a healthy lifestyle and are careful when traveling, you will most likely have no trouble with this nasty infection. Please check with the following reference or more complete information.

—Dr. C.

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