Lecture 12 - Tuberculosis Part I - Nov 3 2009

Tuberculosis Introduction & The Global Picture

November 3rd, 2009 Lecture Notes Page 1 of 16

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What is it?

Historically TB disease known as: •

Phthisis (ancient Greeks)

•

Tabes (Romans)

•

Rajayakshma (India)

•

Consumption (Victorian England)

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TB Infection Vs. TB Disease Begins with latent infection = exposure to TB bacillus Latent infection is asymptomatic Usually affects the lungs and respiratory tract TB can affect other organ systems in the body • • •

Pulmonary disease (primarily) Extrapulmonary disease Systemic infection when lymphatic dissemination spreads TB bacilli throughout body

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Symptoms (Pulmonary disease)

1. 2. 3. 4. 5. 6. 7. 8. 9.

bad cough that lasts longer than 2 weeks pain in the chest coughing up blood or sputum (phlegm) weakness or feeling very tired weight loss no appetite chills fever night sweats.

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The Organism

Tubercle bacilli (Koch, 1882) Mycobacterium tuberculosis complex • • • •

Group of five closely related mycobacteria Slender, slightly curved rod-shaped bacteria Slow growing; generation time (approximately 24 hours) High molecular weight of lipids in their cell walls

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The Organism

-genetic mapping has indicated that bacteria not a mutation of M.bovis (theory that was held until 10 years ago) -million years ago in soil and water in Paleolithic period -traces identified in Egyptian mummies from 3500-400 BC -initial sporadic becoming endemic -AD100 in Mediterranean states and Europe -increased incidence during Industrial Revolution -established in North America by the early 1700s -largely unknown in Africa at the beginning of 1900s spread with European colonization

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TB – “iClicker” 1.

Someone in the world is infected with TB: a) b) c) d)

Every Every Every Every

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week day minute second

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TB – “iClicker” 2. This is the percentage of the world population infected with the TB bacillus: a) b) c) d)

5% 15% 35% 50%

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TB – “iClicker” 3. This is the percentage of people who are infected with TB who become sick at some point in their lifetime: a) b) c) d)

5-10% 15-20% 50% 100%

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TB – “iClicker” 4.

In 2004, the largest number of new cases of TB occurred in: a) b) c) d)

Africa Western Pacific Europe South-East Asia

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TB – “iClicker” 5.

In 2004, the highest per capita incidence of TB occurred in: a) b) c) d)

Africa Western Pacific Europe South-East Asia

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TB – “iClicker” 6.

In 2004, _______ people died from tuberculosis around the world: a) b) c) d)

700, 000 1, 700,000 2, 300,000 3, 000, 000

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TB – “iClicker” 7.

A patient with pulmonary tuberculosis can spread the disease when: a) b) c) d) e)

coughing sneezing talking spitting all of the above

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Estimated Incidence of TB (per 100,000 population), 2007

Maroon=>300 Red=100 - <300 Yellow=<10

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25 Minute Film – Post Reflection on WebCT for ICE!

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