Posts tagged ‘TB’
SHAH ALAM: The mortality rate of tuberculosis (TB) is higher and deadlier than dengue, Selangor Health Department director Datuk Dr Azman Abu Bakar said today.
In Selangor, he said TB affected 4,151 people and claimed 245 lives last year, compared to dengue which caused 24 deaths in the state last year.
He added that TB also causes the most deaths among all the communicable diseases in Malaysia.
“TB is still a problem that haunts us. It is difficult, but not impossible, to achieve zero per cent TB but we need to have close cooperation with all parties.
“Universiti Teknologi MARA (UiTM) today has paved the way for other tertiary institutions in partnering the Health Ministry in creating awareness about TB,” he said during the state’s World Tuberculosis Day celebration at UiTM Puncak Perdana, here, yesterday.
He warned the public that TB was an airborne infection and an infected person could potentially infect 10 to 15 people with just one cough.
“It is very potent so those who show signs of TB, such as coughing continuously for two weeks, coughing with traces of blood, fever and sweating at night, sudden and drastic loss of weight and chest pain while taking deep breaths, should get checked by a doctor immediately,” he said, adding that TB was curable with six months of medication.
The Health Ministry, he stressed, provided the six-month medication for free for both citizens and foreigners in Malaysia.
Health Ministry Disease Control Division TB and Leprosy Sector Head Dr Jiloris F. Dony said the ministry was currently strengthening its strategy in improving awareness of TB through social media and special projects.
“Each patient is allocated a supervisor and at least 10 people who have close contact to the patient is also taught about the disease.
“Besides that, we conduct school health programmes, regular awareness programmes and ensure that every newborn is given vaccination,” he said during a press conference after the celebration.
Two people in England have developed tuberculosis after contact with a domestic cat, Public Health England has announced.
The two human cases are linked to nine cases of Mycobacterium bovisinfection in cats in Berkshire and Hampshire last year.
Both people were responding to treatment, PHE said.
It said the risk of cat-to-human transmission of M. bovis remained “very low”.
These are the first documented cases of cat-to-human transmission…”
Dr Dilys MorganPublic Health England
M. bovis is the bacterium that causes tuberculosis in cattle, known as bovine TB, and other species.
Transmission of M. bovis from infected animals to humans can occur by breathing in or ingesting bacteria shed by the animal or through contamination of unprotected cuts in the skin while handling infected animals or their carcasses.
The nine cases of M. bovis infection in cats in Berkshire and Hampshire were investigated by PHE and the Animal Health and Veterinary Laboratories Agency (AHVLA) during 2013.
The findings of the investigation are published in the Veterinary Recordon Thursday.
What is tuberculosis?
Tuberculosis (TB) is an infectious disease caused by a germ which usually affects the lungs.
Symptoms can take several months to appear and include
•Fever and night sweats
•Blood in your phlegm or spit
Almost all forms of TB are treatable and curable, but delays in detection and treatment can be damaging.
TB caused by M. bovis is diagnosed in less than 40 people in the UK each year. The majority of these cases are in people over 65 years old.
Overall, human TB caused by M. bovis accounts for less than 1% of the 9,000 TB cases diagnosed in the UK every year.
Those working closely with livestock and/or regularly drinking unpasteurised (raw) milk have a greater risk of exposure.
Screening was offered to people who had had contact with the infected cats. Following further tests, a total of two cases of active TB were identified.
Molecular analysis showed that M. bovis taken from the infected cats matched the strain of TB found in the human cases, indicating that the bacterium was transmitted from an infected cat.
Two cases of latent TB were also identified, meaning they had been exposed to TB at some point, but they did not have the active disease.
PHE said it was not possible to confirm whether these were caused by M. bovis or something else.
No further cases of TB in cats have been reported in Berkshire or Hampshire since March 2013.
‘Uncommon in cats’
Dr Dilys Morgan, head of gastrointestinal, emerging and zoonotic diseases department at PHE, said: “It’s important to remember that this was a very unusual cluster of TB in domestic cats.
“M. bovis is still uncommon in cats – it mainly affects livestock animals.
“These are the first documented cases of cat-to-human transmission, and so although PHE has assessed the risk of people catching this infection from infected cats as being very low, we are recommending that household and close contacts of cats with confirmed M. bovis infection should be assessed and receive public health advice.”
Out of the nine cats infected, six died and three are currently undergoing treatment.
Prof Noel Smith, head of the bovine TB genotyping group at the AHVLA, said testing of nearby herds had revealed a small number of infected cattle with the same strain of M. bovis as the cats.
However, he said direct contact between the cats and these cattle was unlikely.
“The most likely source of infection is infected wildlife, but cat-to-cat transmission cannot be ruled out.”
Cattle herds with confirmed cases of bovine TB in the area have all been placed under movement restrictions to prevent the spread of disease.
Researchers say the tuberculosis-causing germ is likely to have grown when ancient man started to live in larger communities, while a separate study finds 39 new genes implicated in drug-resistant TB
PARIS : One of the largest genetic investigations into the microbe which causes Tuberculosis (TB) has revealed that the germ followed early humans out of Africa at least 70,000 years ago.
In a separate study, 39 new genes that drive dangerous drug resistance in this germ, Mycobacterium tuberculosis, have been identified.
TB is one of the deadliest diseases in the medical lexicon and even in the era of advanced antibiotics, it causes between a million and two million deaths each year, mainly in developing countries.
Writing in the journal Nature Genetics, researchers led by Sebastien Gagneux of the Swiss Tropical and Public Health Institute compared the DNA of 259 TB strains from around the world.
They used this to build a “family tree” of the germ, using genetic mutations as a kind of molecular clock to show its pace of evolution.
The comparison shows that the bacterium originated in Africa over 70,000 years ago, coinciding with the migration of anatomically modern humans from their homeland.
With the family trees of Homo sapiens and M. tuberculosis overlapping closely, reseachers says early man and bug most likely lived in close proximity.
“The evolutionary path of humans and the TB bacteria shows striking similarity,” said Gagneux. “We see that the diversity of tuberculosis bacteria has increased markedly when human populations expanded.”
TB’s spread was probably kick-started when humans started to live in larger communities, enabling the germ to be transmitted more efficiently from person to person, the authors speculate.
The germ’s ancient history means the disease is unlikely to have jumped from domesticated animals to humans, as has been seen in so many other bacteria or viruses.
The latest findings could boost the work of drug designers who are embroiled in an arms race with the germ, hoping to outflank it with new treatments before it develops resistance to existing ones.
In one effort to lock down TB, a separate study, also published in Nature Genetics, investigators from Harvard Medical School found 39 new genes implicated in drug-resistant TB in a genomic comparison of 123 strains.
Researchers discovered that some of the genes play a role in regulating the bacterium’s cell walls — a common target for many antibiotics.
But it also turned up evidence that drug resistance is more complex than thought.
A conventional notion is that resistance occurs with a single mutation in a gene.
Instead, this change is likely to be part of a multi-step process that starts with low resistance and then builds up.
“Until now, people assumed that single mutations conferred high-level resistance — a strain either had them or did not — but our results challenge that paradigm,” said Megan Murray, a professor of global health and social medicine, in a press release.
“Knowing that small changes occur early in the evolution of resistance open the door for big changes, or that a single change is a gateway to global resistance, would be important clues in our struggle to outrace evolving drug resistance.”
TEMERLOH : Throughout last year, 890 cases oftuberculosis (TB) were detected in Pahang compared to 788 cases in 2011, with the death rate from the disease at 7.1 per 100,000 people.
State Health director Dr Norhizan Ismail said 112 people died fromtuberculosis last year after long-term coughing and due to other factors such as HIV infection.
“Tuberculosis must be controlled early as it can spread through family members and others closeby,” he said when opening the state-level World Tuberculosis Day commemoration at Felda Lakum, here, yesterday.
Dr Norhizan said based on a World Health Organisation (WHO) report, 1.4million people died from tuberculosis in 2011 out of 8.7 new cases detected thesame year.
He said that since 2000, Pahang managed to exceed the targeted detectionrate of 70 cent proposed by WHO, by achieving 85 per cent in 2011 and the ratebeing increased to 95 per cent this year.– BERNAMA
Many first-choice antibiotics no longer work against some strains of the tuberculosis bacterium
By James GallagherHealth and science reporter, BBC News
There is mounting concern that a rise in “virtually untreatable” tuberculosis poses a threat to countries around the world.
Writing in the Lancet medical journal, the group said governments were “complacent” and “neglectful”.
It called for countries to do more to tackle the problem.
The World Health Organization says nearly nine million people become sick and 1.4 million die from tuberculosis each year.
Some countries are facing problems with drug resistance, with many first-choice antibiotics no longer working against some strains of the tuberculosis bacterium.
It is particularly acute in some parts of eastern Europe and central Asia, where up to a third of cases can be multi-drug resistant, known as MDR-TB.
- A persistent cough, usually for more than three weeks
- Night sweats for weeks or months
- Weight loss
- High temperature
- Shortness of breath
The number of laboratory-confirmed cases of MDR-TB around the world has gone from 12,000 in 2005 to 62,000 in 2011. However, the real figure is thought to be closer to 300,000.
An even more stubborn version, resistant to more antibiotics, is called extensively drug-resistant tuberculosis and has been detected in 84 countries.
“With ease of international travel, and increased rates of MDR tuberculosis in eastern Europe, central Asia, and elsewhere, the threat and range of the spread of untreatable tuberculosis is very real,” the report said.
It argued that countries had spent decades being complacent in their response to the infection and that a “major conceptual change and visionary global leadership” were needed.
“To prevent further cases of multi-drug-resistant and extensively drug-resistant tuberculosis, a radical change in political and scientific thinking, and the implementation of specific measures worldwide, are needed.
“The global economic crisis and reduced investments in health services threaten national tuberculosis programmes and the gains made in global tuberculosis control.”
One of the report’s authors, Prof Alimuddin Zumla, said: “”It’s a growing problem in London and a huge, huge problem in Europe – it’s in our backyard at the moment.”
However, he warned there was “no overnight solution” for tuberculosis.
He said many of the necessary tools, such as antibiotics, had already been developed, but the challenge was using them appropriately in often poor countries.
Prof Zumla argues that Europe overcame tuberculosis by tackling poverty; however, “that’s an ideal that I don’t think is going to happen [for the rest of the world]”, he said.
Dr John Moore-Gillon, a medical adviser for the British Lung Foundation, told the BBC: “They are not scaremongering this at all.
“Tuberculosis is perceived as someone else’s problem, there’s no doubt we need a bit of political leadership.”
He said there had been a “shameful” lack of investment in tuberculosis treatment and research.
“With global population movement, tuberculosis is in everyone’s backyard.”
Tuberculosis attacks the lungs
Some bacteria, including tuberculosis, are able to invade because the body launches the ‘wrong’ immune response, say researchers.
Instead of fighting off tuberculosis, people with a severe infection produce a protein which attacks viruses, the journal Science reports.
About 8.7 million people are infected with tuberculosis every year.
The findings may explain why viruses can make people more susceptible to bacterial infections.
A spring peak in tuberculosis infections may be linked to the effects of viruses circulating in winter, experts suggested.
US researchers first identified the phenomenon using leprosy – which is caused by a similar bacterium to tuberculosis.
Looking at skin lesions in leprosy patients, the team found that two different immune proteins were present.
In those with a milder form of the disease, they found a protein associated with a bacterial immune response – interferon-gamma.
Whereas in patients with a more serious form of leprosy, a protein associated with a viral response – interferon-beta – was prominent.
Further work showed the genes for interferon-beta – the virus-fighting protein – were more frequently expressed in the blood of tuberculosis patients with more severe disease.
The researchers said in those with severe disease, the body was responding as if it was attacking a virus, enabling the bacteria to remain hidden and replicate unchallenged within cells.
Not only is interferon-beta an ineffective weapon against bacteria, it can block the action of interferon gamma – which is when bacteria can gain a foothold, the researchers said.
In the face of a real viral infection it may mean that the attention of the immune system is diverted letting a bacterial infection in.
Prof Robert Modlin, a dermatology and microbiology expert at the University of California, Los Angeles, said the study raises the possibility that a decrease or increase of one of these two proteins could shift the balance from mild to more serious disease.
“We may find that therapeutic interventions to block or enhance specific interferon responses may be an effective strategy to alter the balance in favour of protection against bacterial diseases.”
The results may also help to explain why outbreaks of tuberculosis in winter such as one currently spreading among homeless groups in Los Angeles are quick to take hold.
A potent combination of people sleeping in close quarters in shelters, flu outbreaks diverting the body’s immune response to the viral setting and a lack of vitamin D from sunlight, which also impacts the immune response, may be to blame, they suggested.
“With TB on the rise, this scenario could play out not only in cities in the United States but all over the world,” Prof Modlin said.
Prof Ajit Lalvani, director of the Tuberculosis Research Unit at Imperial College London said there is a spring peak in rates of tuberculosis which have been attributed to low levels of vitamin D.
“But this shows there could be at least one other reason – that other viral infections are leading some months down the line to progression from latent to active TB disease.
“The timing fits, but that remains to be proven.”