Does The Mantoux Test Work?

Tuberculosis is a major cause of distress and worry. This is because it is a disease that makes an individual suffer and also become quite weak and fatigued. The disease can also spread to other people through coughing and sneezing. The problem of tuberculosis is that it is also quite fatal. There had been some difficulties in the proper and accurate diagnosis of the disease. But the introduction of the much used Mantoux test has managed to help the doctors and physicians to find out a lot about the problem. Well, the test would involve some injections. These injections would actually be able to determine whether the person suffers from TB or not.

But does the Mantoux test really work? Let's see then. The main thing involved in this test for diagnosis is the medical solution known as tuberculin. Tuberculin actually contains a good number of strains or extracts of the different mycobacteria. These bacteria are actually responsible for tuberculosis or cowpox in cattle and other domesticated animals. A suitable quantity of tuberculin is suitably injected intradermally to the person, who is under the scanner. As found out in the clinical trials for diagnosis of TB, the skin would produce a visible reaction on the injection of the new germs or bacteria. The most significant effect would be that of indurations or hardness of a slightly raised area of the person's skin.

However, the indurations is not the sole indicator of the presence of TB bacteria in the body. The level of the indurations can easily fluctuate, increase or decrease severely due to the action of other, graver health problems. If the level of indurations crosses the 5mm mark, it would be identified as a result of a HIV infection or some residual action of a previous tuberculosis infection. Then, if the level of skin induration further crosses the scale limit of 10mm, there could be other things which would be revealed like some infections from drug use or more serious problems like diabetes and so on. So, we can see how the Mantoux test can be for the diagnosis of other problems with people as well.

There is another problem which makes the Mantoux tests rather unreliable and also not quite believable. This is the fact that the tests may produce false results and reactions. If the test result turns out to be a positive one, it is not just because of any serious infection of the Mycobacterium. It could be because of bacteria other than those which do actually cause the problem of TB. So, the person may be suffering from problems caused by other Mycobacteria and still produce a falsely positive result in the Mantoux tests. It could also be that the diagnosis of any bacterial infection be false as well. This can be when the positive results are due to the vaccination of the BCG.

When there is no skin indurations, the person is generally believed to be free from any threat of tuberculosis. The person's skin would also be believed to be free from reactions to any other disease or problem of the bacteria and germs. However, this does not necessarily mean that the person is not free from any illness or affliction. The person may not show or exhibit any reaction simply because he or she may be suffering from an immuno-deficiency problem. This problem could render the immune systems to be weak. So, for this purpose, the individual would not be able to exhibit any palpable reaction to the Mantoux test. So, with such problems, the Mantoux tests may not be really reliable.

The Importance of BCG Vaccination

When you baby is born and newly arrived in the world, it would be almost a sworn duty for you, the parent to make sure the child does not suffer any problem or disease. This is not just concerning the future of the child. It is also about starting right at the beginning and taking some modest steps to save your child from further troubles and problems. One such step is that of adequate vaccination. Vaccines will help to build  a natural immunity against the more damaging and severe diseases and afflictions. One of the important vaccinations is that of the BCG. BCG is the abbreviation for Bacillus Calmette-Guerin. This is a vaccination that will help to protect the new born child from the problem known as tuberculosis.

What is the BCG? Well, in simple terms, it is a vaccine that contains predominantly the strains of the bacterium known as mycobacterium bovis. This bacterium is found to be the principal cause behind the problem of cowpox or even tuberculosis in the cows. The bacterium had been initially found to be quite virulent when tested in human bodies. Later, French bacteriologists Albert Calmette and Camille Guerin developed a better and more advanced system of vaccination for TB. This was in 1908 when a weaker and more diluted version of the same strains of the bacteria was now being used in the BCG vaccines. Initially, disaster had been the result with many new-born babies dying of TB.

The BCG vaccination was soon proved to be quite a strong resistance against the hideous disease of tuberculosis. It has been found that the weak and benign strains of the cowpox and bovine TB bacterium will provide an ample protection against the onset of the real problem. People conducting medical diagnosis and treatment have further verified how the action of the BCG vaccines helps in sufficient protection to any person especially to young children. As of late, people in countries like India and other parts of the world have begun to get a BCG vaccine for their infants and newborn babies. But effective as the BCG is, there are still some reasons why it would not be very effective.

The BCG has so far recorded a good figure in terms of people who have been immunized against TB. However, there have been findings, which have questioned about the efficacy or effectiveness of BCG. Often, the positive results have been drastically low in some countries. In other countries, the results have been quite good. What could be the reason behind such a variance? One is the susceptibility of the people to the virus. If some weak strains of the bacterium have already started their action inside people, the new vaccination will not really work in effect. So, this is why often the BCG vaccination does not produce any good results.

There are some other reasons why the bacterium will not work or will work only under specific circumstances. There could be some genetic mutations in the bacterium. This will cause the bacterium to respond quite variably in different conditions and situations. For this reason, the BCG vaccine will not really work for some cases. In some troubled nations like India and Brazil, the BCG vaccination is important and it has been found to work in most cases due to some circumstances. However, this does not happen in nations like USA or UK. Here, the people would be treated of their TB even without the vaccination of BCG.

Bcg Vaccine - Vaccination to Preventing Tuberculosis

What is BCG vaccine?

BCG stands for Bacillus Calmette-Guérin (or Bacille Calmette-Guérin, BCG) is a vaccine against tuberculosis that is prepared to prevent the human tuberculosis diseases.  This  BCG vaccine only effective to prevent tuberculosis from infecting for only 15 years. BCG vaccine is not widely used worldwide to prevent human tuberculosis as it depends on the geographical area where the percentage of tuberculosis is high.

When is the right time to give BCG vaccine?

The used of BCG vaccine for tuberculosis prevention is best used for children under the age of 5. However, in certain cases the BCG vaccination can be taken as early age before 5 and after the children pass the 6 month age to preventing the spreading of tuberculosis. This is due to high level of infections in some countries.

Who should take BCG vaccine?

In most cases, BCG vaccine is recommended to prevent tuberculosis to children who have a negative tuberculin test and children who receive high exposure to tuberculosis infected person and people who have TB caused by strains resistant to isoniazid and rifampin. BCG vaccine also recommended to be taken to healthcare workers who strongly exposed to tuberculosis diseases in their line of work.

Who should not take BCG vaccine?

Immunosuppressed people and a pregnant woman should not be given BCG vaccine. Immunosuppressed people are people who are HIV-infected person. As there are no harmful side effects of the BCG vaccine to the fetus on the womb, it is more likely as a rumor and a further study is needed to prove it. If BCG vaccine is accidentally given to an immunocompromised patient, it can cause disseminated or life-threatening infection.

 What is the reason of BCG vaccine variable efficacy

 There are no static reason for BCG vaccine variable efficacy but a number of reason has been reported as a possible reason to support this hypothesis. As we may know, a number of percentage of tuberculosis infected person are varies accordingly between countries.

1. Background frequency of exposure to tuberculosis.  In high level infection countries the effects of immunization partially low as a large portion of TB germs may have weakened the BCG vaccine.
2. Genetic variation in BCG strains.  Not every BCG vaccine carry the same genetically strains. There is genetic variation in the BCG strains used, and this may explain the variable efficacy reported in different trials.
3. Genetic variation in populations Differences in genetic make-up of different populations may explain the difference in efficacy. The Birmingham BCG trial was published in 1988. The trial was based in Birmingham, United Kingdom, and examined children born to families who originated from the Indian subcontinent (where vaccine efficacy had previously been shown to be zero). The trial showed a 64% protective effect, which is very similar to the figure derived from other UK trials, thus refuting the genetic variation hypothesis.
4. Interference by concurrent parasitic infection Another hypothesis is that simultaneous infection with parasites changes the immune response to BCG, making it less effective. A Th1 response is required for an effective immune response to tuberculosis infection; one hypothesis is that concurrent infection with various parasites produces a simultaneous Th2-response which blunts the effect of BCG.
5.  Exposure to Ultraviolet Light Concentration of ultraviolet light (particularly UVB light) from the Sun may have some effect on efficacy of the BCG vaccine. UVB has been demonstrated to reduce efficacy of BCG vaccine in laboratory guinea pigs. The concentration gradient of UVB light increases geographically closer to the Earth's equator. It is possible, though currently unresearched, that this effect may occur as a result of sunlight-dependent Vitamin D production.

Tuberculosis Treatment System

Tuberculosis Treatment

Tuberculosis, commonly referred to as TB, is an infection that affects the lungs and may also affect bones, joints, the circulatory system and central nervous system. This disease can be highly contagious if left untreated. In 1993, the World Health Organization declared TB to be a world health emergency because of the frequency of infection and the ease in which it spreads. It is estimated that nine billion new cases are reported each year.

As with any disease, it is better to ensure prevention. TB vaccinations are common and highly effective, especially in children. TB vaccinations are very common in the United States as well as other countries. Although a higher percent of children are successfully protected, if adults have not received a TB vaccination it is recommended they get one.

Symptoms of TB include chest pain, coughing, inability to breathe and pneumonia-like symptoms. However, it is also common to be infected and show no outward signs. Diagnosis of the disease will occur with a complete examination including a TB skin test. It is important to minimize the damages by early detection and prompt treatment. This can mean the difference between full recovery and possible death.

Treatment of this disease can be complicated, especially if there are other factors such as HIV. It is recommended that quarantined hospitalization occur to monitor progress and reduce the risk of spreading. Common drug therapies include antibiotics specifically designed for TB treatment such as Isoniazid, Rifampin, Pyrazinamide, Streptomycin and Ethambutol. Unfortunately, there are many strains of tuberculosis that have become resistant to the medications. It is very important for continued monitoring to ensure effectiveness of a drug or combination of drugs.

In the instance where the body is resisting drugs, surgery may be necessary. The portion of the lungs affected may be removed. Also, chest tube drainage may be required. In these cases, recovery percentages are very low. In order to reduce this risk, treatment as early as possible is advised. Patients who have an early diagnosis or are not immune to the drug treatments have a high success rate of complete recovery. Relapses are extremely rare with proper treatment.

With over two billion people affected with tuberculosis in the world, the seriousness of this disease can not be denied. Prevention of the disease is the best way to keep the spreading of it in check. This includes ensuring children are properly vaccinated and all shots are kept up to date. Early detection and treatment are also key factors in guaranteeing complete recovery and minimizing risk of relapse.

Tuberculosis and Its Relationships with 2 Billion People

Tuberculosis, a bacterial infection, most commonly affects the lungs. Tuberculosis can also affect the central nervous system, lymphatic system, circulatory system, genitourinary system, bones and joints. Often Called TB for short, tuberculosis is the most common major infectious disease today. With that title the virus is infecting two billion people which is approximately one-third of the world's population. Nine million new cases of active disease annually, resulting in two million deaths. Most of these cases and deaths are in developing countries.

Ninenty percent of those that are infected have asymptomatic latent TB infection (LTBI). This is alot of numbers: There is a ten percent chance that in the lifetime of LTBI that it will progress to active TB disease. This active disease if left untreated, will kill more than fifty percent of its victims. All of these numbers make tuberculosis one of the top three infectious killing diseases in the world. HIV/AIDS kills 3 million people each year, TB kills 2 million, and malaria kills 1 million.

Tuberculosis is caused by a slow-growing aerobic bacterium that divides every 16 to 20 hours. This division is extremely slow when compared to other bacteria, which tend to have division times that are measured in minutes.

In many patients the infection of Tuberculosis waxes and wanes. Treatment with appropriate antibiotics kills bacteria and allows healing to take place. Areas where Tuberculosis has affected will eventually be replaced by scar tissue. A complete medical evaluation for Tuberculosis includes a medical history, a physical examination, a tuberculintut, a serological test, a chest X-ray, and microbiologic smears and cultures. This is quite an extensive procedure as you can see, but if you look at the numbers above it is a necessary process.

The Sanatoriums Method in Dealing Tuberculosis

The age of Tuberculosis sanatoria began in 1849 when public health tried to isolate the sick persons from the healthy population. The fact that Tuberculosis is actually a contagious disease and can be transmitted from man to man was not yet known.

The idea of Tuberculosis being a curable disease and not a death sentence was first expressed by doctor Brehmer in 1854 after he suffered from the disease himself. As a student he caught Tuberculosis and was sent by his doctor to change the climate and live a healthy life in the Himalaya Mountains. He returned home cured and wrote a debate about how Tuberculosis can be cured.

Brehmer built a sanatorium for his tuberculous patients where they could get dietary food, fresh air, sun shines and a high elevated life.

The Tuberculosis suffering Doctor Trudeau opened the most famous sanatorium in America, Saranac Lake, where he also conducted laboratory testing and investigation concerning the cure of Tuberculosis. Patients in his sanatorium were strictly supervised, had to stay in bed the whole first three months to rest, eat healthy and drink high amounts of milk. Trudeau continued Koch’s studies of identifying the structure and physiology of Mycobacterium in order to understand how it could be killed.

All sanatoriums burned and disposed all the objects of the new income as it was proven the bacteria can for a period of time survive inside the clothes tissues, until it found a new host.

The sanatorium cure spread into entire Europe and America; it provided a dual action against Tuberculosis. Isolation of active cases from the healthy population made it possible to control the spreading of the disease. Secondly, sanatoriums provided the patients with regulate, hospital medical care and a better social and cultural environment.

Frequently, people were brought and interned in sanatorium against their will. Many persons could not understand the benefic consequences of this kind of cure, or even felt depressed. In an age without any sort of chemical medication the self-control, autosuggestion and a good moral played a tremendous role in the healing process.

The era of sanatoriums was over when the first antibiotic against Tuberculosis was discovered. Streptomycin successfully treated the infection and enabled patients to be treated in hospitals or receive home treatment. In order to prevent the development of resistance to antibiotics, a combination of efficient drugs is used in the medication lasting normally at least 6 months, even a whole year.

Diagnose and Treatment of Tuberculosis

Tuberculosis is still a very common disease mostly encountered in low developed countries and areas. TBC localizes especially in the lungs but can also affect kidneys, bones or other tissues.

There are three main diagnosing methods regularly used in hospitals all over the world:

1. The first made in cases of suspicion is the skin testing at Tuberculin, a purified protein derivation that checks the exposure of the patient to the infection. Although he might not have developed the disease, the patient that had contact with the bacteria causing the infection has possibly developed a type of hypersensitivity. The PPD will be injected under the skin and verified after 48-72 hours to detect a possible enlarged papule. A positive result of the testing indicates the prime infection to Tuberculosis. This test is not 100% certain and cannot guide the doctor to a sure diagnose without other investigations.

2. The secondary investigation is the search for Mycobacterium Tuberculosis in the sputum or other organic fluids or tissues.

3. The third but most meaningful testing is the chest X-ray detecting any kind of pulmonary injuries assembling to the ones in Tuberculosis. These three methods must be connected with significant signs and symptoms for Tuberculosis.

After a certain positive diagnose has been established, the doctor must proceed by other kind of tests to find the best treatment and the most adequate drugs to treat Tuberculosis.

As Tuberculosis infection can be caused by different strains of the bacteria, more recent genetic research has improved the speed of diagnose by using the polymerize chain reaction (PCR). Through the strain multiplication of a microscopic bacterial fragment doctors obtain the genetic material required to establish the right treatment.

Prevention methods are also available in TBC cases. The BCG vaccination during childhood decreases the risk of Tuberculin infection at children. A good ventilation of the air in public places disperses the bacteria and reduces the risk of contact. Ultraviolet rays are most helpful in closed environments as they also kill Mycobacterium Tuberculosis, but they cannot guarantee the 100% certainty of prevention.

The basic treatment of Tuberculosis is a combination of more antibiotics found to be efficient against the particular type of bacterial strain. One single antibiotic is likely to lead to resistance developing. The cure must last for at least 6 months but the duration of treatment can go up to 9 months or a whole year. Most common, the combination of Hydrazid, Rifampicin, Pyrazinamid and Ethambutol is used in treating tuberculin infection.

Lately, the entire bacterial genome of Tuberculosis has been decoded. We expect new methods of prevention and treatment in the next following years.