Tuberculosis

Learning Objectives
Explain how bacterial and viral
infectious diseases have a
sequence of symptoms that may
result in death, including
the diseases caused by
Mycobacterium tuberculosis (TB)

What is TB?
TB is an infectious disease that can affect
any part of the body although it is usually
found in the lungs.
Mycobacterium tuberculosis

Between humans
Droplet infection

Mycobacterium

bovis

Between humans and cattle

Milk (unpasteurised)
& droplet infection

Human TB in sputum

1/3 of the World have this disease

30% of Deaths in Africa

Close to 2 million deaths per year

13% Aids Victims will die from TB

There are 2 things wrong or not useful in this information. Can you spot
them?

Estimated tuberculosis incidence (2010) Data are from a WHO report.4

The 22 countries with the highest burden of tuberculosiswhich account
for 80% cases worldwideare labelled.

Chest X-ray of a person with advanced tuberculosis. Infection in both

lungs is marked by white arrow-heads, and the formation of a cavity is
marked by black arrows.

Symptoms
Fever
Night-time

sweating
Loss of weight
Persistent cough
Constant tiredness
Loss of appetite
Coughing up blood

How is it caught?
aerosol infection.
22% of those in close or prolonged
contact with a person carrying the disease
become infected.
Is associated with AIDS people with
immune-suppression caught it more easily.

Course of Infection
1.

Primary infection.

Can last for several months and give no symptoms.

The person infected deals with the infection by their macrophages
engulfing the bacteria that have invaded the lung.
However masses of tissue forms that has dead bacteria and
macrophages in the centre.
These tissues are called tubercules.
After 3-8 weeks the infection is controlled
and the lung heals.
Most primary infections happen in childhood.
White spots are
tubercules. These
are in rabbits lungs.

Second phase.
Active TB.

Happens when a previous infection is no longer controlled or if

the body is overwhelmed by a high dose of bacteria.

What things might trigger a reactivation of TB?

Bacteria multiply rapidly and break down tissue in the lungs

causing spaces where alveoli should be.

How will this affect gas exchange?

The bacteria target T-cells and therefore reduce the production

of antibodies.

Which T-cells will help antibody production?

Eventually TB causes death.

How?

Vaccination

Western Countries - The Bacillus CalmetteGuerin (BCG) vaccine

Attenuated version of M. bovis
What does attentuated mean?

Drugs must be taken for 6-9 months

Drug-resistant strains

Explain this graph

 Discuss

how the theory of an

evolutionary race between
pathogens and their hosts is
supported by the evasion
mechanisms as shown by Human
Immunodeficiency Virus
(HIV) and Mycobacterium
tuberculosis (TB).

How TB evades the Immune

system.
Bacteria have a thick waxy
outer layer which protects
them from attack by
macrophage enzymes. Lie
dormant in the tubercules
until the person has a
weakened immune system.
What selection mechanism
is happening here?

TB can disable two of the

mechanisms a macrophage
uses against bacteria. First
it disrupts the production of
cytokines. Second it stops
the apoptosis of the
macrophage which
normally will happen after
invasion.