Modern Plague:
Every year tuberculosis kills nearly two million people and infects some eight million more. Here a patient in Mumbai, India, is treated for a highly drug-resistant form of the disease.
Image: James Nachtwey VII
In Brief
- Tuberculosis is second only to HIV as the worldwide cause of death from infection, and the pandemic is growing in many places.
- TB is caused by a bacterium. Most cases are treatable, but strains resistant to first- and second-line drugs are on the rise.
- Conventional approaches to developing new antibiotics and vaccines against the disease have mostly failed.
- New tools are enabling scientists to study the TB-causing bacterium in greater detail, offering unprecedented insight into the interactions between pathogen and host. The results are exposing promising new targets for drug therapy
Bubonic plague, smallpox, polio, HIV—the timeline of history is punctuated with diseases that have shaped the social atmospheres of the eras, defined the scope of science and medicine, and stolen many great minds before their time. But there is one disease that seems to have stalked humanity far longer than any other: tuberculosis. Fossil evidence indicates that TB has haunted humans for more than half a million years. No one is exempt. It affects rich and poor, young and old, risk takers and the abstinent. Simply by coughing, spitting or even talking, an infected individual can spread the bacterium that causes the disease.
Today TB ranks second only to HIV among infectious killers worldwide, claiming nearly two million lives annually, even though existing drugs can actually cure most cases of the disease. The problem is that many people lack access to the medicines, and those who can obtain the drugs often fail to complete the lengthy treatment regimen.
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6 Comments
Add CommentBioinformatics: as computer intensive as it seems, it sounds like an excellent candidate for a distributed computing aka 'grid computing' project like the World Community Grid (formed by IBM), which has already collected 218,000 YEARS of spare computer power from volunteers' computers -- which would have been otherwise wasted -- and has used it for non-profit medical research which is shared with the world. Another similar project is Stanford University's 'Folding@Home' project which collects spare PC power to study protein folding -- something which seems to be a key part of this "bioinformatics" process. My website contains a collection of lots of info about grid computing and the WCG any many other projects. I have no financial interest; see www . velek . com for more info.
Reply | Report Abuse | Link to thisBill Velek
Bioinformatics: as computer intensive as it seems, it sounds like an excellent candidate for a distributed computing aka 'grid computing' project like the World Community Grid (formed by IBM), which has already collected 218,000 YEARS of spare computer power from volunteers' computers -- which would have been otherwise wasted -- and has used it for non-profit medical research which is shared with the world. Another similar project is Stanford University's 'Folding@Home' project which collects spare PC power to study protein folding -- something which seems to be a key part of this "bioinformatics" process. My website contains a collection of lots of info about grid computing and the WCG any many other projects. I have no financial interest; see www . velek . com for more info.
Reply | Report Abuse | Link to thisBill Velek
CureTB@Home, I like it!
Reply | Report Abuse | Link to thisDear Editor: As a retired community nurse, I was thrilled to see your article on TB in your March issue, but distressed to discover that in the rush to develop new medicines and medical techniques probably the cheapest and most effective way of reducing the spread of TB is not even mentioned in the article.
Reply | Report Abuse | Link to thisWhen TB was rife in "Western" countries new drugs and forcing infectious people into "sanatoriums" were certainly a help, but probably the most important public health measure was the banning of spitting in public places.
When I returned to North America as a teenager in the mid 1950s there were signs up everywhere threatening $50 fines for anyone caught spitting in a public place. Within a very few years spittoons had disappeared completely, hardly anyone was chewing tobacco, it became socially unacceptable to spit in public, and the sanatoriums were emptying out (to soon be filled with the victims of the polio epidemic).
Now, If even a small amount of money and education to enforce similar measures were put on the governments of just India, China, Pakistan and Bangladesh (all nations where public spitting is very common), almost half of the world's population would benefit immediately. And there are two extra bonuses - the ban would work for drug-resistant strains as well as ordinary forms, while also reducing the spread of other serious airborne illnesses such as influenzas.
With a little political willpower this is doable now, very cheap, and very effective. Such laws controlling public spitting should be enforced in every country.
Sincerely,
John Hill
Cooktown, Queensland,
Australia
TB can be cured if the patient sticks to a tedious six to nine month antibiotic regimene. In the first half of the twentieth century developed nations employed antibiotics with alacrity, and along with other improved public health measures diseases like TB were all but extirpated in places like the US. In fact, as Randolph Nesse M.D. and George Williams PhD write in their book Why We Get Sick, "In 1969 the US Surgeon General felt justified in announcing that it was 'time to close the book on infectious diseases'." Well the book has not only been re-opened since then, but it has been re-written. Now, some of the bacteria causing TB has evolved to withstand the first-line antibiotics, so-called multidrug resistant TB (MDR TB). Barry and Cheung say to effectively fight off the defiant MDR TB "requires therapy for up to two years with second-line anti-TB drugs that produce severe side effects". Even worse, there are cases of Extreme Drug Resistant TB (XDR TB) that can go virtually unscathed by all lines of defense put against it. "People with tuberculosis resistant to multiple drugs have about a 50% chance of survival, note Nesse and Williams. "That is about the same as before antibiotics were invented!" they warn.
Reply | Report Abuse | Link to thiswww.mentalpestilence.com
1.Timely spotting by the health workers and relatives and Prompt diagnosis of the disease by the GP is crucial, cos it is only EARLY consumption Tb Lung, that can be cured completely with the present drugs. -2.local improvised spittoons, earth pits, ash mounds, kill the TB.-3.A fairly wide hanky/ hand towel supplied to all wet coughers prevent airborne germs infecting the neighbor,.-4. teaching Tb knowlej is simple :a. uncontrolled cough of a few weeks, b.low grade evening fever, c. night sweats, d.phlegm coughed up, with a little blood or a lot of blood or no blood, e. loss of appetite w gradual LOSS of weight ; these be the symptoms to watch for in the common form , lung Tb.. #The germ can invade ANY organ system in the body, esply glands, skin,bone, genitals.# diagnosis is usually easy. # faithful take of the drug course is imperative. even under DOTs the staff / pt. can cheat! Ambulatory Rx. is useful only for the early case.# and all health edu stress on the spread thru airborne germ.//george pradhan,mb/1950,ECFMG, india.
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