Tuberculosis Tuberculosis is an infectious disease caused mainly by the intracellular bacterium Mycobacterium tuberculosis, which affects the lungs

mostly. Tuberculosis is one of the most common human infections with about 9.2 million cases reported in 2006, causing 1.7 million deaths. The number of deaths and infections are dropping, according to a new study done in 2010 people infected have decreased to 8.8 million and deaths dropped to 1.4 million, . People infected with Tuberculosis are mainly present in developing countries. Tb is spreadthrough the air thus People infected can spread the bacteria just by breathing, coughing or sneezing. When one coughs, talks or sneezes millions of particles from their respiratory tract are expelled into the atmosphere that can remain suspended in the air for hours. If someone is infected with tb then infectious bacteria will be expelled aswell. Another wway that someone could get infected is by drinking milk that is from cattle which has tb. Animls can also get infected but by a different bacteria Mycobacterium bovis.People that have a problem with their immune system or are poorly nourished are much more likely to develop active tb than a helthy person that gets proper nutrition. Tb affects the respiratory system. It all begins when th m Tuberculosis reaches the pulmonary alveoli and starts to reproduce int he primary infection, often symptomless. In A healthy immune system there will be an inflammatory response, this will cause a mass of tissue to form called a tubercule. This mass is contains dead bacteria and macrophages. It takes about 8 weeks for the immiune system to get the bacteria under control thus the inflammation dies down and the lung tissue can begin to heal. Mycobacterium tuberculosis can avoid the immune system, this means some bacteria may survive the inflammatory response. These bacteria produce a thick waxy layer which efficiently protects them from the enzymes of the macrophages. The bacteria remain dormant deep in the tubercles in the lungs until that person isnt properly nourished or their immune system is weakend due to HIV for example. Active ttuberculosis is now produced. The active phase may be due to a new infection where many bacteria are taken down into the lungs and the immune system doesnt respond properly. More likely is the reactivation os an older infection rather than a new one, 80 % of people with active tb is due to old infections reactivating. Active tb may occur in the firsy weeks of infection or years later. 1 in 10 of people infected will develop full blown active TB. Now the bacteria starts to rapidly reproduce in the lungs causing symptoms like fever and night sweats, weight loss. Also due to damage of the lungs, specifically the alveoli vreak down, sympotms include chest pains, breathing difficulties and coughing. Sputum may be brought up because of the coughing, as the lung gets damagedmore blood may be brought up with the sputum. Others symptoms are weight loss and fatigue. What is more mycobacterium tuberculosis can reduce antibody production by affecting te Tcells hence the immune system becomes less efficient. As mentioned previously TB causes fever an inflammatory response to stop the bacteria reproducing. the bacteria stop

reproducing above 42C but human enzymes begin to denature at 40C. The patient may die before the bacteria are inhibited. Ultimately TB causes death. Death may because the person cannot get enough oxygen to their lungs due to the large inefficient air spaces in the alveoli, or it may be because they lack nutrition and their organs fail. Moreover TB weakens the immune system thus maing the person with the disease prone to other death threatening diseases for example pneumonia. There are a number of ways in which TB can be diagnosed and since millions of people worldwide get infected diagnosis must be as cheap and easy as possible. Chest x-ray is one of them, if the person has TB there will be damage to the lungs these areas will show up as apque areas. This test though isnt the most efficient for diagnosing TB since other diseases give the same x-ray results. Another method is testing the persons sputum for the mycobacterium tuberculosis. However this is slow since the bacteria need to be cultured and this specific bacteria is relatevly slow at reproducing. One more test for tb is skin testing this involves an injection in the fore arm, 2 to 3 days later the person will go back to the doctor, if the site of injection is hard and swollen it means the person is infected. Tb is a bacterial infection so the main treatment is with the use of antibiotics. Many different antibiotics are used for many months. Both bacteriosidal and bacteriostatic antibitiscs are used so any mycobacteria that is resistant to one drug can be destroyed b the other drugs present, both fast and slow metabolising bacteria are affected. The patient must continiue to rake antibiotics until the test show he I s ot infected anymore. Controlling TB isnt an easy task, firstlyliving stantards must be improved, the importance of hygiene should be explained to people for example covering their mouth when sneezing or coughing.M. Bovis can be controlled by heating the ilk before its drunk moreover in the uk 30000 infected cows were slaughtered. A vaccine for immunisation to TB exists its called BCG, it contains an attenuated mycobacterium. TB cases have decreased, as the use of the vaccine has increased.