Tuberculosis #2

Mooooooonths ago I made a little note about how I think I might like to march off to Jamaica or the slums of Bangalore and save, if I could, even one life from tuberculosis.  This notion, this dream, this novelty still lives in my cerebral cortex. Most of the weeks since that April post 4 months ago I have spent a couple of hours or more studying TB and the people who fight it.  They're called TB controllers, but mostly it's lack of control.  TB infects about 25% of the human race.

It's a germ that gets inside immune system cells (alveolar macrophages in the lungs, to start) and would normally just plain be consumed by them.  Yet this particular bacterium sends out chemicals or lightening or Flash Gordon rays that stop the lysosome in the cell from releasing the poisons that will kill the germ.  There's a standoff.  Many people have "latent" or idle or inactive tuberculosis.  They were exposed, it got a foothold, usually in their lungs, and now it's hiding in there with a bunch of guards that can't kill it but can contain it.  Unless it breaks out and multiplies, never hurts you or maims you or makes you lose 30 pounds or ends your life.

About 4,000 people die a day around the world from TB.  A day.  The weaker the health care and general prosperity system is, the better the TB.  In the US/developed world, it's out on the fringes infecting the homeless, the AIDS patient, those taking drugs that suppress the immune system, those on street drugs.  Also diabetics.  In Russia, sub-Saharan Africa, and the Indian subcontinent, it can be anybody.  In one recent year close to half of all TB deaths were in India.  And it's a fairly treatable disease in many cases.  You have to take the drugs for months, though. 

TB has new life because of the AIDS epidemic.  To an extent, we had it on the run, but not now.  The "current outbreak' dates to the 1980s when HIV infection became widespread, hampering larger numbers of immune systems than the status quo in, say, 1975.  I think about 1 AIDS patient in three dies of TB or with TB.