P-MAPA

The main focus of the work of Farmabrasilis has been the development of the immunomodulator P-MAPA. Although this compound was originally intended for cancer treatment and has been shown to have anti-tumour activity, P-MAPA also modulates the production of interferon-gamma and interleukin-10, known to be key substances in the body’s defences against TB, malaria and other infectious diseases. This had led Farmabrasilis to put forward a new approach to treating patients with these conditions - including those co-infected with HIV - which would involve attempting to re-establish patients’ immunocompetence by adjuvant immunotherapy with P-MAPA.
Farmabrasilis welcomes contact with other individuals and organizations interested in the further development of the proposed approach.
Tests carried out by Tuberculosis Antimicrobial Acquisition and Coordinating Facility (TAACF) under contract signed by Farmabrasilis and US NIAID has shown that P-MAPA is active against M. tuberculosis in vivo
http://blog.tropika.net/tropika/2010/04/19/news-from-farmabrasilis/

Chicago history of sanitarium

In January 1964, fifteen-year-old Kathleen Felters from Chicago’s Lawndale neighborhood on the West Side was admitted to the Municipal Tuberculosis Sanitarium at 5601 N. Pulaski on Chicago’s Far North Side. She was transferred to the sanitarium by bus from Cook County Hospital, accompanied by a nurse.
At the time Kathleen weighed 97 pounds and had just undergone a pulmonary lobectomy, which in her case meant the right lower lobe of her lung was removed. She had had TB for six months before she was taken to Cook County.
Kathleen wasn’t the first in her family to reside at the sanitarium. In all, at least ten members of her family suffered from TB. From the 1940s to the 1960s six were admitted: her father, who died of TB at the sanitarium in March 1957; her grandfather; her uncle’s wife; two of her uncle’s siblings; and her uncle’s niece, who died as an infant from TB.
http://francesarcher.wordpress.com/2010/04/19/1813/

Finland, vaccination, immigrants

The end of vaccinations for tuberculosis did not bring about an increase in cases of actual tuberculosis among children. The disease still exists in Africa and Russia, and many immigrant children are still vaccinated in Finland. Terhi Kilpi of the National Institute for Health and Welfare emphasises, however, that immigration does not pose an additional risk for tuberculosis among Finns.
“This has been seen very well in Sweden. Tuberculosis among the population has become increasingly rare, even though the country has taken in immigrants for decades. It should also be noted that young children with tuberculosis do not infect others,” Kilpi explains.
Finland stopped routinely vaccinating children against tuberculosis in 2006 because it was found to cause more harm than good, with bone infections as a possible side effect
http://www.yle.fi/uutiset/news/2010/04/giving_up_tb_vaccinations_increases_lymph_node_infections_1615205.html

California: San Diego/Tijuana statistics

Once a disease thought to have been eradicated across most of the developed world, today the incidence of tuberculosis (TB) is again on the rise. As the most heavily trafficked land border crossing in the world with close to 60 million crossings a year and an unparalleled level of bidirectional border crossers, the San Diego-Tijuana border region is particularly vulnerable to infectious diseases such as TB. The incidence of TB in San Diego remains one of the highest in the nation and was double the U.S. national average in 2007. The incidence of TB in Tijuana is over 2.8 times the Mexican national average.
The report identified several concrete steps that could be taken by the government, business and the philanthropic sector to reduce the incidence of TB in the San Diego-Tijuana border region by investing in laboratory diagnostics, prevention, infection control, expanded surveillance and expanded cooperation of area employers in TB health education, diagnosis and treatment. In the case of laboratory diagnostics no such services currently exist in Baja California yet could be provided for less than $213,000 a year permitting the state to accurately identify, detect and diagnose tuberculosis cases using cultures and drug susceptibility testing.
Additional key findings:
Over 600 cases of pulmonary TB were confirmed and reported annually in Tijuana in 2006 and 2007 with an overall rate of 46 per 100,000 inhabitants, which is substantially higher than rates in neighboring Mexican states.
Since 2000 there has been an average of over 300 new TB cases per year in San Diego County, of which nearly 40 percent were born in Mexico according to the San Diego County Health & Human Services Agency.
The estimated cost of TB in San Diego is a minimum of $21.3 million annually for an average of 300 cases. This includes approximately $12.7 million in lost earnings for patients due to their disease.
http://www.businesswire.com/portal/site/home/permalink/?ndmViewId=news_view&newsId=20100419007352&newsLang=en

Georgia: Illegal Immigrants with Tbc

Last month, 50 students and teachers at Lilburn Middle School in Gwinnett County, Ga., a suburb of Atlanta , tested positive for tuberculosis exposure, and four have been confirmed to have an active case of TB.. While that news may be shocking to most, it is nothing new. In October 2009, about 200 students at the county’s Norcross High School underwent testing, after TB was discovered at the school. Of course, Atlanta is a known ‘sanctuary city’ for illegal aliens.It is often said that the flood of illegal immigrants into this country is reaching 'epidemic proportions.' While that statement is true, it is just as true that the illegal immigrants pouring over the U.S./Mexican border are endangering this country with actual epidemics. Tuberculosis, hepatitis, dengue fever, chagas, and even leprosy are being imported into the U.S. inside the bodies of illegal aliens. A virtual 'hot-zone' of disease can be found in this nations border states. Illegal immigrants have set up so-called ;colonias’ just inside the states of New Mexico, Texas, and Arizona. The shanty towns are comprised mostly of cardboard shacks and huts made with cast-off building materials. They have no sanitation, and are surrounded by mounds of garbage. The estimated 185,000 illegals share their makeshift towns with armies of rats. Of course, diseases only common to Central and South America run rampant in these places.
http://www.examiner.com/x-35821-Immigration-Reform-Examiner~y2010m4d18-Another-inconvenient-truth-about-illegal-immigrationdisease

Badger spreads bovine Tbc

On Queen guitarist Brian May's blog, the hottest topic isn't his searing solo on "We Will Rock You" or the operatic ambition of "Bohemian Rhapsody." It's the badger "genocide" Mr. May fears is headed to the Welsh countryside.Mr. May is part of a large badger-loving community trying to block government plans to kill up to 1,000 of the furry creatures in coming months. Farmers blame the animals for spreading tuberculosis to cattle. A group called Badger Trust has spent close to £100,000 ($154,000) on a legal battle to try to stop the planned killing.A plan to kill up to 1000 badgers in Wales has British rock star Brian May up in arms. WSJ's Jeanne Whalen reports.In March, Mr. May joined badger activists in Wales at a Swansea courthouse, where Badger Trust's wigged lawyers tried to convince a judge that the planned cull is illegal. "What was at stake? Badgers, yes, but much more; the whole question of how we treat the other animals on our planet was in microcosm represented here," Mr. May later wrote on his blog, Brian's Soapbox.Badgers, whose tunneling in gardens bothers some people, too, have long spread bovine TB to cattle, by urinating on fields where they graze, and by salivating on feed. But periodic culls haven't stopped the TB. Meanwhile, the badger-extermination campaign has helped create a devoted band of protesters. The U.K. has at least 60 badger-protection groups. http://online.wsj.com/article/SB10001424052702304628704575185541819675272.html?mod=WSJ_hp_editorsPicks

Fiji: grant to aid prophylaxis and treatment

THE treatment of about 650 tuberculosis patients over the next five years will be carried out by the National TB Program via a $20million grant from the Global Fund.The project will involve the distribution of TB prophylaxis to more than 750 children.The Ministry of Health will manage and co-ordinate the grant.The recipients include the Red Cross Society, Fiji Nursing Association and the Fiji School of Medicine, Fiji National University, National TB Program, National Reference Laboratory, Fiji Pharmaceutical and Biomedical Services Centre and the Health Information Unit.The Global Fund will support the ministry to reduce the burden of TB in Fiji.The funds will be distributed in two phases starting this month and ending in June 2012.The Health Ministry will upgrade laboratory systems in the main divisional facilities, support the National TB program and strengthen the pharmaceutical inventory.The health sector believes the grant will allow the State to decentralise the role of government health services for TB, allowing more private practitioner and civil society organisation participation. The grant aims to bring about effective community outreach programmes.
http://www.fijitimes.com/story.aspx?id=144682

Kentucky: Sanatorium in Louisville

Right in the heartland of the United States, in Louisville, Kentucky, lays the Waverly Hills Sanatorium. It originally opened in 1910 as two-story hospital to accommodate 40 to 50 tuberculosis patients, but the building we see today was built in 1926 and has always been dedicated to the treatment of tuberculosis patients, a fairly common disease back in the early 20th Century.Many people lost their lives at the sanatorium. It is estimated that as many as 63,000 could have died inside the walls of this concrete building, but that’s only a legend. Some researchers say the true number of deaths is about 8,000, pretty far from the alleged 63,000. http://theparanormalborderline.blogspot.com/2010/04/haunted-places-waverly-hills-sanatorium.html

Ethiopia: active case finding

Active case finding is to find, diagnose, and treat and follow up tuberculosis patients in the local communities.
To find out the efficacy of community-based case finding, we did a community randomized trial and cost-effectiveness analysis in south Ethiopia. The trial Ethiopia aimed to evaluate if community health workers could improved smear-positive case detection and treatment success rates (Datiko and Lindtjørn, 2009 and Datiko and Lindtjørn, 2010).
The study showed that involving of health extension workers (HEWs) in sputum collection and treatment improved smear-positive case detection and treatment success rate, possibly because of an improved service access. This finding has policy implications and could be applied in settings with low health service coverage and a shortage of health workers.
Recently, National TB Control Programme in Ethiopia started to decentralize case finding and treatment to local communities (in Ethiopia called kebeles) using community based-treatment by health extension workers.
http://bernt.b.uib.no/2010/04/16/active-case-fining-to-improve-tuberculosis-control/

UK: prison death from tbc

A MAN has died from tuberculosis while being held in Cardiff Prison, the Western Mail has learned.
Tests will now be carried out on those inmates and staff who were in close contact with the unnamed man, who died on April 2.
The Western Mail understands the man was in his 30s and was an illegal immigrant from Cameroon.
http://www.walesonline.co.uk/news/health-news/2010/04/16/cardiff-prison-inmates-and-staff-to-be-tested-after-tb-death-91466-26254053/

Tuberculosis: the return of the white plague? Statistics

The last few weeks have seen an explosion of reports concerning the status of the worldwide fight against tuberculosis, largely precipitated by World TB Day last month on March 24. Tuberculosis was once considered a disease of the past, an illness, like diphtheria, thought to have faded away with the Victorian era as a serious cause for concern. Indeed, for many people today any mention of TB might still be more likely to evoke thoughts about the death of Helen Burns due to “consumption” in Jane Eyre, than to incite any sense of panic. And while many people from more developed countries might not have ever known anyone personally to have been infected with TB (I know I haven’t), the reality is that TB has resurged as one of the most pervasive and deadly diseases in the world. What was once historically referred to as the “white plague” is today thought to cause one death every 15 seconds. It is estimated that approximately one third of the world’s population is currently infected with TB, with higher incidence rates found primarily in African and Asian countries, and 1 in 10 of these latent infections resulting in death. The rate at which TB spreads is equally alarming: the most recent data estimates that a new person is infected with TB every second of every day.
http://www.practicalethicsnews.com/practicalethics/2010/04/the-last-few-weeks-have-seen-an-explosion-of-reports--concerning-the-status-of-the-worldwide-fight-against-tuberculosis-larg.html

North Korea: US assistance in tbc diagnosis

Stanford researcher Sharon Perry PhD, an infectious disease specialist, has been working in North Korea with a team of American health specialists to develop the country’s first diagnostic laboratory to test drug-resistant tuberculosis. The Democratic People’s Republic of Korea, as the hermit country is formally known, witnessed a resurgence of TB in the 1990s after famines plagued the country.
The TB Diagnostics Project is being led by the Bay Area TB Consortium, which Perry directs, and the Nuclear Threat Initiative, a Washington nonprofit group working to strengthen global security. The program came about after a team of North Korean health officials visited California and met with Stanford and Bay Area tuberculosis experts in 2008.
It’s unusual for any outsiders to visit North Korea, but extremely rare for Americans. Safe to say that it's an unprecedented partnership between U.S. researchers and health officials in North Korea. So far, Perry has ventured there three times and is soon to return for a fourth visit.
http://scopeblog.stanford.edu/archives/2010/04/perry-podcast.html

Aerosol delivery of medication

The researchers from the University of North Carolina School of Pharmacy, Chapel Hill, North Carolina; and Harvard School of Engineering and Applied Sciences, Cambridge, Massachusetts, report their findings in the April 2010 issue of the journal Antimicrobial Agents and Chemotherapy.
Epidemic rates of HIV/TB coinfection as well as emerging multidrug-resistant (MDR) and extensively drug-resistant (XDR) TB strains are contributing to increased TB-associated deaths worldwide. PA-284, a compound capable of being formulated into a dry powder, has not only shown promising activity against MDR and XDR but has also proven safe and effective in patients coinfected with HIV and TB. Previous studies showed that PA-284 was well-tolerated in tablet form, however, side effects such as headache and stomach discomfort were reported. Aerosol delivery of PA-284 directly to the primary site of infection would limit systemic exposure and ultimately eliminate potentially bothersome side effects.
In the study guinea pigs were used to evaluate the effects of PA-284 aerosols on TB infection. One month following infection with TB some guinea pigs received high daily aerosol treatments while others received low daily treatments for 4 weeks. Lung and spleen analysis of guinea pigs receiving the high dose of aerosol PA-284 showed less inflammation, bacterial burden and tissue damage.
"The present studies indicate the potential use of PA-824 dry powder aerosols in the treatment of TB," say the researchers.
http://www.sciencedaily.com/releases/2010/04/100415134412.htm

Australia: statistics & compulsory isolation

A COURT has ordered that a homeless man with tuberculosis be kept in hospital against his will to protect the public from an outbreak of the disease.
The man, referred to in court documents as TC, has been subjected to a public health order that he be detained ''subject to such security as may be considered necessary in hospital''.
Most patients with tuberculosis are hospitalised when infectious and then closely monitored during treatment while they live within the community.
The NSW Health Department applied to the Administrative Decisions Tribunal to extend a previous public health order made in January to detain the man at Royal Prince Alfred Hospital for treatment after the ''very difficult and unco-operative patient'' had resisted numerous treatment attempts.
The Chief Health Officer of NSW, Dr Kerry Chant, certified that the man's behaviour, while suffering from the disease, was a danger to public health.
There are about 1000 new cases of tuberculosis in Australia each year.
http://www.smh.com.au/nsw/homeless-tuberculosis-sufferer-to-be-held-in-hospital-20100415-shsa.html

Bovine tbc regulation change

The U.S. Department of Agriculture on Thursday issued a federal order that will allow beef producers in modified bovine tuberculosis zones to transport their breeding animals across state lines without undergoing costly TB testing.
The news is positive for beef cattle producers in Minnesota especially, which has been under split-state status since Oct. 10, 2008. Minnesota had been a TB-free state up until 2005, when tuberculosis was discovered in a beef cattle herd in northwest Minnesota. Since then, 12 herds in Beltrami and Roseau counties have had confirmed cases of the disease.
“The important part is that we haven’t found an infected herd for over a year now,” said Bill Hartmann, executive director of Minnesota’s Board of Animal Health (BAH) and state veterinarian. “We continue to test 300 herds every year in that modified accredited area of the state, and we haven’t found any infection in over a year.”
http://www.dglobe.com/event/article/id/35170/group/News/

Texas: DOTS, quarantine?

In Dallas County, there's a disease so dreaded that people diagnosed with it must agree to take medication for six months and allow a government worker to watch them swallow the pills every day.
The number of TB cases in the county fell below 200 for the first time last year. It is so serious that the medication is hand-delivered wherever an infected person can be found, even if it's in a cardboard box under a downtown bridge.
"We can meet them at a McDonald's or a 7-Eleven or a gas station," said Tesfa Kidane of Dallas County Health and Human Services.
He oversees the 10 outreach workers who religiously keep track of and treat Dallas County's nearly 200 tuberculosis patients – an approach so successful that TB cases dropped 11 percent in 2009 from the previous year.
Why such a hard-nosed approach for a disease that has nearly been stamped out in the U.S. and is highly treatable?
"This disease, if left untreated and unchecked, could decimate a community," said Dr. Garry Woo, medical director of tuberculosis control for Dallas County.
And if patients refuse to take their meds or miss too many of these rendezvous, county health officials will have them quarantined.
http://www.dallasnews.com/sharedcontent/dws/news/localnews/stories/DN-tuberculosis_15met.ART0.State.Edition2.4cd92e0.html

Florida: tbc case

DELAND -- A health investigation is under way after news that a student at Atlantic High School has been diagnosed with tuberculosis.
http://www.cfnews13.com/Health/YourHealth/2010/4/9/high_school_student_diagnosed_with_tuberculosis.html?cid=rss

Abdominal tbc

BACKGROUND:: Abdominal tuberculosis (TB) includes infection of the gastrointestinal tract, peritoneum, mesentery, abdominal lymph nodes, liver, spleen, and pancreas. The most common forms of abdominal TB in children are adhesive peritonitis and nodal disease. PATIENTS AND METHODS:: We report our experience with abdominal TB treated in our hospital from 1995 to 2008. RESULTS:: Thirteen patients (3 boys and 10 girls) of mean age 9.8 years were diagnosed as having abdominal TB. Eight patients presented with abdominal distension and abdominal pain. Fever was seen in 4 patients. One patient had surgical abdominal pain and 2 had abdominal mass. Two patients had coexisting pleural effusion and 1 of them had multifocal TB. Abdominal TB involved peritoneum in 9, abdominal lymph nodes in 7, gastrointestinal tract in 3, spleen in 2 patients, and liver in 1. Ascitic fluid analysis of 9 patients showed exudative fluid with predominately lymphocytes. Laparotomy was performed in 3 patients. The diagnosis of abdominal TB was confirmed histopathologically in 5 patients and microbiologically in 3. The remaining patients had been diagnosed by ascitic fluid diagnostic features, abdominal imaging, tuberculin skin test, history of exposure, and a positive response to antituberculous treatment. Twelve patients completed the antituberculous therapy without any complications. One patient with multifocal TB had neurological sequelae. CONCLUSIONS:: In the areas with a high prevalence of tuberculosis and confirmatory investigations are inadequately available, treatment may be initiated, based on strong clinical diagnosis and supportive investigations. In such situations, it is the response to therapy that indirectly proves the diagnosis.
http://medicine.journalfeeds.com/gastroenterology-hepatology/j-pediatr-gastroenterol-nutr/abdominal-tuberculosis-in-children/20100414/

Azerbaijan: drug resistant tbc in released prisoners

The work on the continuation of treatment of released prisoners with drug-resistant form of tuberculosis has been launched in Azerbaijan, the Ministry of Justice Chief Medical Office head Rafael Mehdiyev said in an interview with Trend.
"Treatment is held under control for released prisoners with drug-resistant form of tuberculosis to be fully treated. We want to expand the scope of activities in this regard, " the department head said.
Mehdiyev said that the activity to continue treatment after release of prisoners with a resistant form of tuberculosis is based on the agreement reached by the Chief Medical Office, Institute for Lung Diseases and the International Committee of the Red Cross (ICRC).
"The prisoners is a special category of people with mentality, requiring an individual approach. In some cases, detainees released under various pretexts, begin to shy away from treatment. It was agreed to achieve full recovery of these individuals to avoid such facts. Therefore, the corresponding work is being held", the department head said.
http://en.trend.az/news/society/rights/1668794.html

Michigan: Deer & Cattle tbc

CHEBOYGAN COUNTY -- Wildlife officials are on high alert in Cheboygan County after a deer tests positive for tuberculosis.
The 3 1/2 year old doe was located in the southeastern corner of the county.
The Michigan Department of Natural Resources and Environment will test at least 300 deer within a 10 mile radius by the end of the year.
This "circle" testing will be in effect for at least 5 years after the last TB positive deer is found on surveillance.
Last month a cattle herd tested positive for tuberculosis in Emmet County. As a result, all cattle herds within a ten mile radius has to be tested in the next six months.
http://www.uppermichiganssource.com/news/story.aspx?id=443819