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Tuberculosis in the AIDS era; more prevalent than AIDS, deadlier than some forms of cancer, not enough attention is being focused on the silent plague.

Q: What are the most common symptoms of tuberculosis?

A: Symptoms often resemble those of influenza. Other symptoms include sudden weight loss, low persistent fever, chronic fatigue, and heavy sweating, especially at night. Later stages of the disease's development include cough with sputum that becomes progressively thicker, yellowish and tinged with blood.

Q: Is there an effective vaccine to prevent tuberculosis?

A: Vaccination consists of introducing a strain of bacille calmetta Guerin (BCG), an attenuated form of tuberculosis bacterium. Some health authorities are enthusiastic about its effectiveness; many dispute its safety.

Q: How is the germ responsible for tuberculosis described?

A: The scientific name is Mycobacterium tuberculosis humanis, also known as tubercle bacillus. It is part of a large family of bacteria, including one group that causes tuberculosis in cows, polluting the milk supply. Leprosy is another disease that owes its existence to the microbe which grows best in darkness and in moist places but can survive only up to two hours in direct sunlight. Bacteria of this species have been known to emerge virulent after being stored for over ten years. The ability to reproduce is awesome; a single organism will replicate itself within a month into the billions. It travels in airborne droplets.

Q: How is tuberculosis transmitted?

A: By inhalation of the mycobacterium coughed or sneezed into the air by a person in the contagious phase of the disease. It is usually curable but can be fatal when left untreated.

Q: If treated, how long does it take for the disease to be arrested?

A: Not every case is treated successfully; but when the prognosis is good, the individual becomes noncontagious within two or three weeks.

Q: Under what conditions do the tuberculosis germs thrive?

A: Poor ventilation, lack of sunlight in enclosed areas, stagnant air, and crowded shelters, subways, or elevators all contribute to heightening an individual's vulnerability to infection.

Q: Since not everyone who breathes the germ comes down with tuberculosis, what is the secret of resistance?

A: It is estimated that as much as 90 percent of the population may have harbored the tubercle bacillus at some time in their lives. The immune system, in these cases, manages to fight off the infectious invasion.

Others, less fortunate, merely succeed fin having the antibodies of the immune system only encase the germ, keeping it immobile forever or until immunity drops and tuberculosis develops. (Read the case of Eleanor Roosevelt, page 4, this issue.)

Q: What is the relationship between the AIDS virus and the bacterium responsible for tuberculosis?

A: The human immunodeficiency virus (HIV) gradually incapacitates the immune system, predisposing the individual to many microbes, including the tubercule bacillus. AIDS patients are especially vulnerable to tuberculosis (TB).

Q: Can the rise in tuberculosis cases be attributed to the influx of immigrants into the United States during the past decade?

A: Although tuberculosis is proliferating among immigrants from Asia, Latin America, the Caribbean, and other countries where tuberculosis is rampant, our native population is equally vulnerable to deteriorating conditions in the United States attributable to homelessness, drug addiction, degenerative lifestyles, and poor nutrition.

Q: Tuberculosis is considered a disease of the lungs. How frequently does it lodge in other organs of the body?

A: The germ enters the body through the lungs, joins the blood stream, and may settle in various organs. Because it thrives best in the abundance of oxygen in the lungs, the tubercle bacillus prefers invading the lungs. The liver, lymph nodes, bone marrow and spleen also fight the invader as it attempts to penetrate those organs. The organs can resist only so long as the immune system operates healthfully. Otherwise, in many instances, tuberculosis of any of those organs can develop.

If the germ passes successfully into the blood stream or lymphatic system, it spawns infection throughout the body. It is then called miliary tuberculosis and will affect membranes surrounding the heart and may invade the stomach and intestines, bones and joints, genitals, and urinary tract. Miliary TB is the most rapid and fatal form of the disease.

Q: Why do doctors recommend the use of two or more drugs in combination for the effective treatment of tuberculosis?

A: The consensus of opinion among doctors treating TB is that germs are given the opportunity to develop resistance to even the most potent drug if given alone.

Tuberculosis germs are slow to die because they can be killed only when they are reproducing. It is for this reason, some doctors claim, that it is important to continue these medicines to the point of cure, approximately nine months' duration.

Q: Can the overcrowding of prisons contribute to the resurgene of tuberculosis?

A: Prehaps prisons are a breeding ground for tuberculosis. Inmates are tested only when the enter prison, but seldom afterward. Important health measurers for the community would be to review inmates' health recovers periodically. Social conditions, at their best, pose problems in a prison setting, pose from family, lack of sanitary conditions, and missing occupational grafification engender stress, leading to vulnearbility to diesase.

Q: The affliction may be rare, but cases of thyroid tyberculosis seem to be missed in usual check-ups. What should doctors look for?

A: Only about seven percent of tuberculosis appears in the thyroid gland because its location is secondary to a tuberculosis process elsewhere in the body.

Swelling of the neck is the most consistent sign, and dysphagia (inability to swallow normally) is usually present. These manifestations are sometimes misdiagnosed as cancer.

Q: Has pasteurization made the milk supply 100% safe?

A: Pasteurization is alleged to destroy Mycobacterium bovis, the bacterium that infects cows and is capable of producing tuberculosis in humans. Cases of TB are seen in patients who claim to have been drinking pasteurized milk throughout their lifetime. Although the U.S. Department of Agriculture has been regulating testing cows for tuberculosis, some states do not require pasteurization but permit the sale of milk from cows periodically certified by a veterinarian to have negative tuberculin tests findings and no evidence of disease.

Q: Name some of the diseases associated with TB that are often misdiagnosed.

A: Kidney disorders, beginning with a single kidney, are sometimes tubercular. Physicians should test urine of every kidney patient for tubercle bacillus content. Another serious disorder, tuberculous meningitis, may be mistaken for TB in its early stages because of mild symptoms, such as low-grade fever and slight headaches.

Q: Is there a recommended diet to accompany orthodox treatment of tuberculosis?

A: A therapeutic diet should not be much different than one used for a preventive diet. To boost the immune system, all sources of toxin-producing foods should be eliminated. Dairy products, fish, chicken, seafood, and all meats contain large amounts of fat, toxins and bacteria. Substantial amounts of nutrients are recommended, especially vitamin C and betaq carotene.

Q: Few doctors consider the value of an excellent functioning intestinal tract to be pertinent to disease prevention or as treatment of a disease. Is this an old-fashioned ideal?

A: The avoidance of emphasis on the subject of constipation is bewildering. Unless the body rids itself of waste and its accompanying hordes of bacteria, the burden on the immune system is compounded. (See Nutrition Health Review, Issue #19.)

Q: To what extent does tuberculosis ebb and flow, coming and going over the years?

A: It is an ancient disease. Evidence has been found in Egyptian skeletons dating back to 3600 B.C.

Epidemics of contagious diseases have cycles, never really disappearing. At the onset they rise rapidly, reach a plateau, then gradually recede, spanning months or decades. Tuberculosis has longer cycles, ebbing and flowing between centuries. In the 16th and 17th centuries it returned with the establishment of towns and cities, encouraged by the filth and crowding of these places. In our own time, vulnerability may be attributed to a decline in immunity caused by stress, pollution, inadequate nutrition, and proliferation of deleterious chemicals in the body.

Since no man is an island, diseases that affect the poor can also spill over into the domain of the wealthy. Tuberculosis does not seem to respect economic borders.

Q: Why and when was the disease known as consumption changed to the term tuberculosis?

A: For hundreds of years, in almost every language spoken on earth, people called the deadly disease consumption because its effects seemed to reflect the body's consuming itself; invalids wasted away as various organs of the body began malfunctioning. No one knew what caused the illness.

Not until Robert Koch identified the cause to be a bacterium did understanding of the process become part of scientific knowledge. Eventually the disease was named after its perpetrator, the tubercle bacillus.
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Title Annotation:Special Issue: Tuberculosis
Publication:Nutrition Health Review
Date:Jun 22, 1991
Previous Article:The challenge of consumption ... the great killer ... the white plague ... and under its modern name - tuberculosis.
Next Article:Cause of death of president's wife misrepresented or misdiagnosed.

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