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.

The Evolutionary Race.

http://biophiliablog.wordpress.com/ca
tegory/nerdy-news/page/2/

In the book, Alice Thorough the

Looking Glass Alice complains
that she is exhausted from
running, only to find she is still right
where she started from. The Red
Queens reply: Now, here, you
see, it takes all the running you
can do to keep in the same place.
If you want to get somewhere else,
you must run at least twice as fast
as that. As Van Valen
(evolutionary biologist), described
it, the best a species can do to
survive, he said, is to respond to
an adversarys adaptations, quickly
and without pause.

Question.

How does the possession of the evasion

mechanisms of TB support the concept of
an evolutionary race between the
pathogens and their hosts?

4 marks).

Answer

Pathogens are essentially parasites and their host will recognise

them as non-self. The pathogen has to survive inside its host and
in order to do so it must stop the hosts immune system from
attacking it. (1).The TB bacterium has evolved two systems. Its thick
waxy covering survives enzyme attack by macrophages. Only the
thickest coverings survive and those bacteria with inferior coverings
have been killed. Therefore the ones with the thickest coverings
have been selected. (1) TB has also learnt to survive inside
macrophages and therefore is protected as it is inside a cell that the
body regards as self. Once more natural selection means that only
the most successful bacteria survive and their characteristics get
passed on. (1).Only if the host can evolve more potent enzymes to
digest the waxy coat or mechanisms that prevent the TB from living
inside the macrophages will it start to win the race. (1).