Tuberculosis

genetics assignment

1. MUHAMMAD IMRAN SIDDIQUE S1F17BSZL0095 CLASS:- BS(H)ZOOLOGY (VI) COURSE:- GENETICS TOPIC:- tuberculosis

2. CONTENTS Definition Introduction History Causes Symptoms Risk factors Types of Tuberculosis Complications Diagnosis

3. CONTENTS Treatments Prevention TB SPREAD Vaccinations Tuberculosis tests Types of tuberculosis tests Dots Tb and HIV Co-infection References

4. DEFINITION What is tuberculosis? Tuberculosis (TB) is a potentially fatal contagious disease that can affect almost any part of the body but is mainly an infection of the lungs. Tuberculosis (TB) is a dreaded bacterial infection. It has been known to mankind since ancient ages. It was commonly called “consumption” at the turn of the last century because of the way the disease seemed to “consume” the individual it affected.

5. INTRODUCTION Tuberculosis (TB) is a bacterial infection caused by a germ called  Mycobacterium tuberculosis . The bacteria usually attack the lungs, but they can also damage other parts of the body. TB spreads through the air when a person with TB of the lungs or throat coughs, sneezes or talks. If you think you have been exposed, you should go to your doctor for tests as soon as possible. You are more likely to get TB if you have a weak immune system.

6. HISTORY Tuberculosis  (TB) is believed to have been present in humans for thousands of years. Skeletal remains show that prehistoric humans (4000 BC) had tuberculosis, and tubercular decay has been found in the spines of Egyptian mummies (3000-2400 BC). Due to the variety of its symptoms, TB was not identified as a unified disease until the 1820s, and was not named tuberculosis until 1839 by J.L. Schonlein .

7. HISTORY

8. HISTORY During the 17th century, exact pathological and anatomical descriptions of tuberculosis began to appear. In 1679, Sylvius wrote his  Opera Medica , in which he was the first to identify actual tubercles as a consistent and characteristic change in the lungs and other areas of consumptive patients. The earliest references to the infectious nature of tuberculosis also appeared in 17th century Italian medical literature.

9. HISTORY In 1854, Hermann Brehmer proposed the idea that tuberculosis was indeed a curable disease. The introduction of the sanatorium cure provided the first big step toward treatment for tuberculosis. Brehmer himself was a TB patient. His doctor advised him to move to a healthier climate, so he spent some time in the Himalayas and came home cured. This experience moved him to build the first sanatorium, a place where patients could get plenty of fresh air and good nutrition. This setup became the blueprint for the subsequent development of sanatoriums.

10. SYMPTOMS OF TB There aren’t any for latent TB. You’ll need to get a skin or blood test to find out whether you have it. There are usually signs if you have active TB disease . They include: A cough that lasts more than 3 weeks Chest pain Coughing up blood Feeling tired all the time Night sweats Chills Fever Loss of appetite Weight loss

11. CAUSES Tuberculosis (TB) is caused by a type of bacterium called Mycobacterium tuberculosis. It's spread when a person with active TB disease in their lungs coughs or sneezes and someone else inhales the expelled droplets, which contain TB bacteria. Although TB is spread in a similar way to a  cold or the flu , it isn't as contagious. You would have to spend prolonged periods (several hours) in close contact with an infected person to catch the infection yourself. For example, TB infections usually spread between family members who live in the same house. It would be highly unlikely for you to

12. WHO'S MOST AT RISK? Anyone can get TB, but those at greatest risk include people: who live in, come from, or have spent time in a country or area with high levels of TB around three in every four TB cases in the UK affect people born outside the UK in prolonged close contact with someone who's infected living in crowded conditions with a condition that weakens their immune system, such as HIV having treatments that weaken the immune system, such as chemotherapy or biological agents who are very young or very old the immune systems of people who are young or elderly tend to be weaker than those of healthy adults in poor health or with a poor diet because of lifestyle and other problems, such as drug misuse , alcohol misuse , or homelessness

13. Traveling or living in certain areas The risk of contracting tuberculosis is higher for people who live in or travel to areas that have high rates of tuberculosis and drug-resistant tuberculosis, including: Africa Eastern Europe Asia Russia Latin America Caribbean Islands Poverty and substance use Lack of medical care.  If you receive a low or fixed income, live in a remote area, have recently immigrated to the United States, or are homeless, you may lack access to the medical care needed to diagnose and treat TB. Substance use.   Use of IV drugs or excessive alcohol weakens your immune system and makes you more vulnerable to tuberculosis. Tobacco use .  Using tobacco greatly increases the risk of getting TB and dying of it.

14. Where you work or live Health care work.  Regular contact with people who are ill increases your chances of exposure to TB bacteria. Wearing a mask and frequent hand-washing greatly reduce your risk. Living or working in a residential care facility .  People who live or work in prisons, homeless shelters, psychiatric hospitals or nursing homes are all at a higher risk of tuberculosis. That's because the risk of the disease is higher anywhere there is overcrowding and poor ventilation. Living in or emigrating from a country where TB is common .  People from a country where TB is common may be at high risk of tuberculosis infection. Living with someone infected with TB .  Living with someone who has TB increases your risk.

15. HOW IS TB SPREAD? The infection is spread when a person with an active TB infection in their lungs coughs or sneezes near a person without the infection. The bacterium is released in the expelled droplets and is inhaled by the healthy person. Tuberculosis, however, is not a contagious disease unlike other infections like flu, the common cold etc. It affects people with a lowered immunity more commonly than those with an intact immune system.

16. PREVENTING THE SPREAD OF TB If you have active TB of the lungs, you can infect other people. For that reason, your doctor will tell you to stay home during the first few weeks of treatment, until you’re no longer contagious. During that time, you should avoid public places and people with weakened immune systems, like young children, the elderly, and people with HIV. You’ll have to wear a special mask if you have visitors or need to go to the doctor’s office. Or your health care provider may admit you to the hospital until TB germs are no longer expelled in your cough. You may be hospitalized for a longer period if you cannot reliably take your medications, do not have stable housing, or have a multidrug resistant strain of TB. The goal is to prevent the spread of the disease.

17. TUBERCULOSIS TYPES TB infection doesn’t mean you’ll get sick. There are two forms of the disease: Latent TB.   You have the germs in your body, but your immune system stops them from spreading. That means you don’t have any symptoms and you’re not contagious. But the infection is still alive in your body and can one day become active. If you’re at high risk for re-activation -- for instance, you have HIV, your primary infection was in the past 2 years, your chest X-ray is abnormal, or your immune system is compromised --- your doctor will treat you with antibiotics to lower the risk for developing active TB.   Active TB.   This means the germs multiply and can make you sick. You can spread the disease to others. Ninety percent of adult cases of active TB are from the reactivation of a latent TB infection.

18. TUBERCULOSIS TYPES Pulmonary TB Extrapulmonary TB Skeletal TB Miliary TB Genitourinary TB Gastrointestinal TB Liver TB TB meningitis TB peritonitis TB pericarditis Cutaneous TB

19. PULMONARY TB Pulmonary TB is active TB that involves the lungs. It’s likely what most people think of when they hear tuberculosis. You contract it by breathing in air exhaled by someone who has TB. The germs can remain in the air for several hours. Along with the general symptoms of TB, a person with pulmonary TB may also experience: persistent cough lasting three weeks or longer coughing up blood coughing up phlegm chest pain shortness of breath

20. EXTRAPULMONARY TB Extra-pulmonary TB: TB that involves parts of the body outside of the lungs, such as the bones or organs. Symptoms depend on the part of the body affected. TB lymphadenitis: TB lymphadenitis is the most common type of extra-pulmonary TB and involves the lymph nodes. It tends to affect the cervical lymph nodes, which are the lymph nodes in your neck. But any lymph node can be affected. Symptoms: Swollen lymph nodes may be the only symptom you notice. But TB lymphadenitis can also cause: fever fatigue unexplained weight loss night sweats

21. SKELETAL TB Skeletal TB , or bone TB, is TB that spreads to your bones from your lungs or lymph nodes. It can affect any of your bones, including your spine and joints. While skeletal TB is rare, it’s been on the rise in some countries with high rates of HIV transmission and AIDS, which both weaken your immune system. Symptoms: Initially, skeletal TB doesn’t cause symptoms. But over time, it can cause general active TB symptoms in addition to: severe back pain stiffness swelling abscesses bone deformities

22. MILIARY TB Miliary TB is a form of TB that spreads in your the body, affecting one or several organs. This type of TB often affects the lungs, bone marrow, and liver. But it can also spread to other parts of the body, including the spinal cord, brain, and heart. Symptoms: Military TB causes general active TB symptoms in addition to other symptoms, depending on the body parts involved. For example, if your bone marrow is affected, you may have a low red blood cell count or a rash.

23. GENITOURINARY TB Genitourinary TB is the second most common typeTrusted Source of extrapulmonary TB. It can affect any part of the genitals or urinary tract, but the kidneys are the most common sites. It usually spreads to the area from the lungs through the blood or lymph nodes. Genitourinary TB can be spread through intercourse, though this is  rareTrusted Source. People with this type of TB often develop a tuberculous ulcer on the penis or in the genital tract. Symptoms: Other symptoms of genitourinary TB depend on the parts affected and may include: testicular swelling painful urination decreased or interrupted flow of urine pelvic pain back pain decreased semen volume infertility

24. LIVER TB Liver TB is also called hepatic TB. It occurs when TB affects the liver. It accounts for less than 1 percent of all TB infections. Liver TB can spread to the liver from the lungs, gastrointestinal tract, lymph nodes, or the portal vein. Symptoms of liver TB include : high-grade fever upper abdominal pain liver enlargement jaundice

25. GASTROINTESTINAL TB Gastrointestinal TB is a TB infection that involves any part of the gastrointestinal tract, which extends from the mouth to the anus. This type of TB causes symptoms similar to other gastrointestinal conditions, such as  Crohn’s disease. Symptoms of gastrointestinal TB Symptoms of gastrointestinal TB depend on the area of the tract infected and may include: abdominal pain loss of appetite weight loss change in bowel habits, such as diarrhea or constipation nausea vomiting an abdominal mass you can feel

26. TB MENINGITIS Also known as  meningeal tuberculosis TB meningitis spreads to the meninges , which are the membranes surrounding the brain and spinal cord. TB can spread to the meninges from the lungs or through the bloodstream. Unlike other types of meningitis that develop quickly, TB meningitis usually develops gradually. Symptoms It often causes vague symptoms in the beginning, including: aches and pains fatigue loss of appetite persistent headache low-grade fever nausea and vomiting As the condition progresses, it can also bring on: severe headaches sensitivity to light neck stiffness

27. TB PERITONITIS TB peritonitis is TB that causes inflammation of the peritoneum, which is a layer of tissue that covers the inside of your abdomen and most of its organs. It affects 3.5 percent Trusted Source of people with pulmonary TB and as many as 58 percent Trusted Source of people with abdominal TB. Symptoms Of TB Peritonitis: Ascites and fever are the most common symptoms of TB peritonitis. Ascites is a buildup of fluid in the abdomen that causes abdominal swelling, bloating, and tenderness. Other symptoms include: nausea vomiting loss of appetite

28. TB PERICARDITIS TB pericarditis occurs when TB spreads to the pericardium. This consists of two thin layers of tissue separated by fluid that surround the heart and hold it in place . It can present as different types of pericarditis , including constrictive pericarditis , pericardial effusion, or effusive-constrictive pericarditis . Symptoms of TB pericarditis include: chest pain fever palpitations shortness of breath cough

29. CUTANEOUS TB Cutaneous TB affects the skin. It’s very rare, even in countries where TB is common. There are several different types of cutaneous TB, and it can spread to other parts of the body. symptoms of cutaneous TB are usually sores or lesions in different areas, particularly the: elbows hands buttocks area behind the knees feet These lesions may be: flat and painless purplish or brownish-red wart-like in appearance small bumps ulcers abscesses

30. DIAGNOSIS OF TB Tuberculosis Diagnosis There are two common tests for tuberculosis, but they don’t tell you whether you have latent or active TB: Skin test.   This is also known as the Mantoux tuberculin skin test . A health care worker injects a small amount of fluid into the skin of your lower arm. After 2 or 3 days, they’ll check for swelling in your arm to determine your results. If your results are positive, you probably have been infected with TB bacteria. the results can be false positive. If you’ve gotten a tuberculosis vaccine called bacillus Calmette -Guerin (BCG), the test could say you have TB when you really don’t. The results can also be false negative, saying that you don’t have TB when you really do, if your infection is recent. You might get this test more than once.

31. TYPES OF SKIN TEST Positive skin test:   This means the person’s body was infected with TB bacteria. Additional tests are needed to determine if the person has latent TB infection or TB disease. Negative skin test:   This means the person’s body did not react to the test, and that latent TB infection or TB disease is not likely. There is no problem in repeating a TB skin test. If repeated, the additional test should be placed in a different location on the body (e.g., other arm). The TB skin test is the preferred TB test for children under the age of five.

32. DIAGNOSIS OF TB Blood test .  These tests, also called interferon-gamma release assays or IGRAs, measure the response when TB proteins are mixed with a small amount of your blood. If you have a positive skin or blood test, your doctor will probably give you a chest X-ray or CT scan to look for changes in your lungs. They also might test for TB bacteria in your sputum, the mucus that comes up when you cough. These results will help diagnose latent or active TB.

33. TREATEMENT OF TB Your treatment will depend on whether you have latent TB or active TB. If you have latent TB, your doctor will probably give you medications to kill the bacteria so you don’t develop active TB. If you start to see any of the symptoms of active TB, call your doctor right away. Your doctor will treat active TB with a combination of medications. You’ll take them for 6 to 12 months. Whether you have latent or active TB, it’s important to finish taking all of your medications, even if you feel better after starting them.

34. TYPES OF TB TREATEMENT Treatment for Latent TB There are two types of TB -- latent and active. Depending on your risk factors, latent TB can re-activate and cause an active infection. That’s why your doctor might prescribe medication to kill the inactive bacteria -- just in case. These are the three treatment options: Isoniazid  (INH) : This is the most common therapy for latent TB. You typically take an isoniazid antibiotic pill daily for 9 months. Rifampin  ( Rifadin ,  Rimactane ) : You take this antibiotic each day for 4 months. It’s an option if you have side effects or contraindications to INH. Isoniazid and  rifapentine : You take both of these antibiotics once a week for 3 months under your doctor’s supervision.

35. TYPES OF TB TREATEMENT Treatment for Active TB If you have this form of the disease, you’ll need to take a number of antibiotics for 6 to 9 months. These four medications are most commonly used to treat it: Ethambutol ( Myambutal ) Isoniazid Pyrazinamide Rifampin Your doctor may order a test that shows which antibiotics will kill the TB strain. Based on the results, you’ll take three or four medications for 2 months. Afterward, you’ll take two medications for 4 to 7 months. You’ll probably start to feel better after a few weeks of treatment. But only a doctor can tell you if you’re still contagious. If you’re not, you may be able to go back to your daily routine.

36. TREATMENT FOR DRUG-RESISTANT TB Treatment for Drug-Resistant TB If you have a TB strain that doesn’t respond to the usual medications used to treat TB, you have a drug- resistent strain. This means that you will be treated with a combination of second-line drugs, which may be less effective. You will need to take these drugs for a longer period of time. If several types of medications don't do the job, you have what doctors call “multidrug-resistant TB.” You’ll need to take a combination of medications for 20 to 30 months. They include: Antibiotics called fluoroquinolones An injectable antibiotic, such as  amikacin  ( Amikin ),  capreomycin  ( Capastat ), and  kanamycin Newer antibiotic treatments, such as  bedaquiline  ( Sirturo ),  ethionamide  ( Trecator ), and para -amino salicylic acid. These are given in addition to other medications. The new drug Pretomanid is used in conjunction with bedaquiline and linezolid.Scientists are still studying these medicines. A rare and serious type of the disease is called "extensively drug-resistant TB." This means that many of the common medications -- including isoniazid , rifampin , fluoroquinolones , and at least one of the antibiotics that are injected -- don't knock it out. Research shows that it can be cured around 30% to 50% of the time.

37. SIDE EFFECTS OF TREATMENT Side Effects Of Treatment Tell your doctor right away if you have any of the following symptoms: Fever for 3 or more days Pain in the lower abdomen Itchiness or a rash Nausea, vomiting, or no appetite Yellowish skin or eyes Dark or brown urine Tingling, burning, or numbness of the hands and feet Fatigue Easy bruising or bleeding Dizziness It’s important to take every dose of your antibiotics. Don’t stop, even if you feel better. If you don’t kill all of the bacteria in your body, the remaining germs can adapt and become drug-resistant.

38. VACCINATIONS BCG vaccine The bacille Calmette-Guérin (BCG) is a vaccine for active TB disease. It is often given to infants and children in countries with high TB rates. It offers limited protection from the disease. In the US, the BCG vaccine is only given to a very small population in consultation with a TB expert. 9 The BCG vaccine can cause a false positive tuberculin skin test (TST) result Interferon-gamma release assays (IGRAs ) are not affected by previous BCG vaccination status.

39. TUBERCULOSIS COMPLICATIONS Tuberculosis Complications A healthy immune system fights the TB bacteria. But if you have any of the following, you might not be able to fend off active TB disease: HIV or AIDS Diabetes Severe kidney disease Head and neck cancers Cancer treatments such as chemotherapy Low body weight and malnutrition Medications for organ transplants Certain drugs to treat rheumatoid arthritis,  Crohn’s disease, and psoriasis Babies and young children also are at greater risk because their immune systems aren’t fully formed.

40. TUBERCULOSIS COMPLICATIONS Complications Without treatment, tuberculosis can be fatal. Untreated active disease typically affects your lungs, but it can spread to other parts of your body through your bloodstream. Examples of tuberculosis complications include: Spinal pain .  Back pain and stiffness are common complications of tuberculosis. Joint damage .  Tuberculosis arthritis usually affects the hips and knees. Swelling of the membranes that cover your brain (meningitis).  This can cause a lasting or intermittent headache that occurs for weeks. Mental changes also are possible. Liver or kidney problems .  Your liver and kidneys help filter waste and impurities from your bloodstream. These functions become impaired if the liver or kidneys are affected by tuberculosis. Heart disorders .  Rarely, tuberculosis can infect the tissues that surround your heart, causing inflammation and fluid collections that may interfere with your heart's ability to pump effectively. This condition, called cardiac tamponade , can be fatal.

41. TUBERCULOSIS TESTS Types of TB tests Different tests are used to diagnose TB, but a healthcare provider will usually start by checking for swollen lymph nodes and listening to someone’s breathing with a stethoscope. Next, they’ll likely do some additional testing to determine whether someone has active or latent TB.

42. MANTOUX TUBERCULIN SKIN TEST (TST) TST is performed by injecting a small amount of tuberculin into the skin of the forearm. The skin will be monitored for a reaction 48 to 72 hours after the injection. A positive skin test indicates that TB bacteria is present, and additional tests are needed to determine if it’s active or latent. Blood tests Blood tests can help to confirm or rule out active or latent TB. The tests measure your immune system’s reaction to TB bacteria. There are two blood testsTrusted Source approved by the Food and Drug Administration for TB: T-SPOT TB test (T-Spot) QuantiFERON -TB Gold In-Tube test (QFT-GIT).

43. TUBERCULOSIS TESTS Imaging tests Following a positive skin test, a healthcare provider may order a chest X-ray or CT scan. These tests produce images that may show changes in the lungs caused by active TB. Sputum tests Sputum is the mucus that comes up when you cough. Healthcare providers sometimes collect sputum samples and test them for different strains of TB bacteria, including antibiotic-resistant types. The results of sputum tests are helpful in choosing the best course of treatment. The bottom line There are many types of TB and ways of testing for them. If there’s any chance you’ve been exposed to TB-causing bacteria, make an appointment with your healthcare provider. TB can become life-threatening if left untreated, but most people make a full recovery with quick treatment.

44. PREVENTIONS OF TB Tuberculosis Prevention To help stop the spread of TB: If you have latent TB, take all of your medication so you don’t develop active TB, which is contagious. If you have active TB, limit your contact with other people at work, school, or home. Cover your mouth when you laugh, sneeze, or cough. Wear a surgical mask when you’re around other people during the first weeks of treatment. If you’re traveling to a place where TB is common, avoid getting close to or spending a lot of time in crowded places with people who have TB. Children in countries where TB is common often get the BCG vaccine. It isn’t recommended in the United States. Other vaccines are being developed and tested.

45. PREVENTIONS OF TB 1 )Mask 2) BCG vaccine 3) Regular medical follow up 4) Isolation of Patient 5) Ventilation 6) Natural sunlight 7) UV germicidal irradiation

46. DOTS (DIRECTLY OBSERVED TREATMENT) DOTS - Directly observed treatment , short-course DOT means that a trained health care worker or other designated individual provides the prescribed TB drugs and watches the patient swallow every dose.

47. TB AND HIV CO-INFECTION How does human immunodeficiency virus (HIV) infection affect TB? The HIV, or the AIDS virus, helps TB germs make you sick because it weakens your immune system. If you are infected with HIV and with TB germs, you have a very big chance of getting  TB disease . The TB germs are much more likely to become active and attack your lungs and other parts of the body. If you think you may have   HIV infection , talk to your doctor about getting an HIV test. If you have  HIV infection  and  TB infection , you must get treatment right away to keep from getting sicker. Take your medicine exactly the way your doctor or health care worker tells you. TB drugs are very strong. They can treat  TB infection  and  TB disease , even in people with  HIV infection .

48. REFERENCES : https://www.healthline.com/health/types-of-tuberculosis#takeaway https://www.webmd.com/hiv-aids/guide/aids-hiv-opportunistic-infections-tuberculosis https://www.mayoclinic.org/diseases-conditions/tuberculosis/symptoms-causes/syc-20351250 https://www.cdc.gov/tb/publications/factseries/tbandhiv_eng.htm https://www.tspot.com/education/tb-eradication-dm/?utm_source=microsoft&utm_medium=ppc&utm_campaign=brandmessage