1. TUBERCULOSIS Paige Derouin

2. History Began infecting the first human ancestors as long as 500,000 years ago In 1882 – claimed the lives of 1 in 7 people Ran rampant in crowded European and American cities March 24 – Robert Koch discovers Mycobacterium tuberculosis Koch’s discovery allowed scientists to begin working on a treatment and vaccine for TB. 1908 - Albert Calmette and Camille Guérin: BCG vaccine o First used in 1921 preventatively

3. History Cont’d 1943 - microbiologist Selman Waksman discovered streptomycin 1970s – Most people believe TB is completely irradiated 1998 – genetic sequencing of Mycobacterium tuberculosis 2006 – first case of extensively drug resistant TB in South Africa 2008 – 49 countries reported cases of extensively drug resistant TB

4. Incidence In 2008 highest incidence was in Southeast Asia 98% of TB related deaths occur in developing countries In the US, there were 4.2 cases per 100,000 people in 2008 Most of the US cases occurred in Florida, Texas, California, and New York

5. World Incidence 2006 World map showing reported cases of tuberculosis per 100,000 citizens. Red = >300, orange = 200-300; yellow = 100-200; green 50-100; blue = <50 and grey = n/a.

6. Mycobacterium tuberculosis Rod shaped, gram positive bacterium Infection begins with phagocytosis into a macrophage can remain inside the host in a dormant form and reactivate later

7. Diagnosis  Diagnosis is based on:  Symptoms Producing cough, chest pain, night sweats, fatigue, fever  Medical history  TB tests Tuberculin Skin Test Blood Tests  Chest X-Rays  Diagnostic microbiology Sputum smear – acid-fast bacilli

8. TB Tests  Tuberculin Skin Test  Injection of fluid into the skin of the lower arm  48-72 hours later – checked for a reaction  Diagnosis is based on height of the skin  Blood Test  Newer test  Based white blood cells’ response to the test  Results available in 24 hours  http://www.youtube.com/watch?v=s3v8M2Q6AGI&feature =channel http://www.youtube.com/watch?v=s3v8M2Q6AGI&feature =channel

9. Treatment Latent TB Not symptomatic or contagious Usually treated with Isoniazid for 9 months Confirmed with a chest X-Ray Infectious TB Treatment is very expensive Treated in phases - Isoniazid, Rifampicin, Pyrazinamide and Ethambutol 1. Usually 3 drugs 2. 2 different drugs

10. Treating Drug Sensitive TB

11. Treating Drug Resistant TB

12. Treating Extensively Drug Resistant TB

13. Problems with Treatment  Very long treatment  Large number of drugs is expensive  Resistant Strains  3 rd World countries

14. Steps to Prevention  WHO’s Stop TB Strategy  DOTS – reduce deaths from TB by 50% by 2015, eliminated by 2050  March 24 – World TB Day  Research for a new vaccine to replace or boost BCG

15. Works Cited  “I am stopping TB” image. : http://www.tac.org.za/community/files/stop- tb_medium.jpghttp://www.tac.org.za/community/files/stop- tb_medium.jpg  Treating extensively drug resistant TB: http://www.niaid.nih.gov/topics/tuberculosis/Understanding/WhatIsTB/Sci entificIllustrations/Pages/extensivelyDrugResistantIllustration.aspx http://www.niaid.nih.gov/topics/tuberculosis/Understanding/WhatIsTB/Sci entificIllustrations/Pages/extensivelyDrugResistantIllustration.aspx  Treating drug resistant TB: http://www.niaid.nih.gov/topics/tuberculosis/Understanding/WhatIsTB/Sci entificIllustrations/Pages/multidrugResistantIllustration.aspx http://www.niaid.nih.gov/topics/tuberculosis/Understanding/WhatIsTB/Sci entificIllustrations/Pages/multidrugResistantIllustration.aspx  Treating drug susceptible TB: http://www.niaid.nih.gov/topics/tuberculosis/Understanding/WhatIsTB/ScientificIllu strations/Pages/firstLineIllustration.aspx http://www.niaid.nih.gov/topics/tuberculosis/Understanding/WhatIsTB/ScientificIllu strations/Pages/firstLineIllustration.aspx  Mycobacterium: http://www.students.stedwards.edu/aruiz5/interview.htmhttp://www.students.stedwards.edu/aruiz5/interview.htm  World Incidence: http://commons.wikimedia.org/wiki/File:Tuberculosis_reported_cases_2006.PNG http://commons.wikimedia.org/wiki/File:Tuberculosis_reported_cases_2006.PNG