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Dr. C's Journal, Medicine

Dr. C’s Journal: Some Facts Regarding Tuberculosis

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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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Dr. C's Journal, Medicine

Dr. C’s Journal: 2022-23 Respiratory Infections

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You should get your flu shot this year. Not only has he influenza Genie been kept in its bottle by Covid precautions, and overdue for a bad year, but the H3N2 serotype circulating around is a good match for today’s vaccine; you may have been disappointed by the lack of protection in the past, due to the vaccine poorly matching the prevalent infecting serotype, caused by the rapid change of the virus and slow changes in the vaccine.

With RSV already making a comeback, influenza likely to be bad, and Covid likely a big problem also, You would be well advised to start going back to your masks, keeping your distance, avoiding large groups, and making sure your inside exposures are well ventilated, not to mention getting the most recent covalent Covid shot, which contains BA.1 and BA.2.

The common cold with running nose, sneezing, and nasal congestion, is usually caused by rhinoviruses, of which there are several hundred serotypes, although can be caused by any of the respiratory viruses. Whenever I traveled, I often came back with a cold because my immunity at home was based on the common rhinoviruses at home, and when I traveled, I encountered different types, to which I was not immune. Many other viral types can also cause the common cold including influenza, para influenza, and even coronavirus. In asthmatic children, the rhinovirus also produces an asthmatic response, often severe.

Croup in children is often produced by parainfluenza type one virus.

Bronchiolitis in children is usually caused by RSV. There is currently no vaccine for RSV.

Influenza, the “flu”,  starts out with chills and fever, often settles into the lung. The influenza virus is usually the initiating culprit, but bacterial infection often follows. Coronavirus infection may start as “the flu” with the respiratory symptoms, such as runny nose, sore throat, and cough following.

Pneumonia is often produced by coronavirus, Especially the early strains. The more recent epidemic strains such as BA .1, Seem to have traded increased transmissibility for less lung affinity.

Avian influenza, H5N1 Is highly lethal with pneumonia, but you catch it from birds rather than people at the present time. Watch out if it ever starts spreading from human to human.

Most respiratory infections begin as a viral infection, which are not affected by antibiotics. Bacterial complications, such as  otitis media, sinusitis, and pneumonia may follow, facilitated by the viruses, which lower immune resistance.

There are a number of antiviral agents, especially for coronavirus and Influenza. RSV may have effective treatments, which are needed particularly in babies.

–Dr. C