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This occurs more commonly in immunosuppressed persons and young children.
infection sites include the pleura
the central nervous system in meningitis
the lymphatic system in scrofula of the neck
the genitourinary system in urogenital tuberculosis
and bones and joints in Pott's disease of the spine.
Mycobacterium tuberculosis
an aerobic bacterium that divides every 16 to 20 hours, an extremely slow rate compared with other bacteria, which usually divide in less than an hour.
For example, one of the fastest-growing bacteria is a strain of E. coli that can divide roughly every 20 minutes.
In nature, the bacterium can grow only within the cells of a host organism.
pathogenic mycobacteria
transmit the disease
Each one of these droplets may transmit the disease, since the infectious dose of tuberculosis is very low and the inhalation of just a single bacterium can cause a new infection.
particularly high risk of becoming infected
A person with active but untreated tuberculosis can infect 10–15 other people per year.
medically under-served and low-income populations
patients immunocompromised by conditions such as HIV/AIDS
virulence
duration of exposure
chain of transmission
Pathogenesis
The primary site of infection in the lungs is called the Ghon focus, and is generally located in either the upper part of the lower lobe, or the lower part of the upper lobe.
Further spread is through the bloodstream to other tissues and organs where secondary TB lesions can develop in other parts of the lung (particularly the apex of the upper lobes), peripheral lymph nodes, kidneys, brain, and bone.
T lymphocytes (CD8+) can also directly kill infected cells.
Another feature of the granulomas of human tuberculosis is the development of cell death, also called necrosis, in the center of tubercles. To the naked eye this has the texture of soft white cheese and was termed caseous necrosis.
XVII: The Star
fatality rate
Tissue destruction and necrosis
Affected tissue is replaced by scarring and cavities filled with cheese-like white necrotic material. During active disease, some of these cavities are joined to the air passages bronchi and this material can be coughed up
Other disease states that increase the risk of developing tuberculosis are Hodgkin lymphoma, end-stage renal disease, chronic lung disease, malnutrition, and alcoholism. [1]
XI: Justice
In 2005, the country with the highest estimated incidence of TB was Swaziland, with 1262 cases per 100,000 people
X: The Wheel of Fortune
India has the largest number of infections, with over 1.8 million cases.
People with TB often have symptoms such as red, swollen eyes (which also creates a sensitivity to bright light), pale skin, extremely low body heat, a weak heart and coughing blood, suggesting the idea that the only way for the afflicted to replenish this loss of blood was by sucking blood.
Similarly, but less commonly, it was attributed to the victims being "hagridden"—being transformed into horses by witches (hags) to travel to their nightly meetings, again resulting in a lack of rest.
Spes phthisica
It was also believed that TB sufferers acquired a final burst of energy just before they died which made women more beautiful and men more creative.
In 1815, one in four deaths in England was of consumption; by 1918 one in six deaths in France were still caused by TB. In the 20th century, tuberculosis killed an estimated 100 million people.
After the establishment in the 1880s that the disease was contagious, TB was made a notifiable disease in Britain; there were campaigns to stop spitting in public places, and the infected poor were "encouraged" to enter sanatoria that resembled prisons;
the sanatoria for the middle and upper classes offered excellent care and constant medical attention.
XXI: The World
collapsing an infected lung to "rest" it and allow lesions to heal — a technique that was of little benefit and was largely discontinued by the 1950s
Whatever the purported benefits of the fresh air and labor in the sanatoria, even under the best conditions, 50% of those who entered were dead within five years (1916).
Explanation of the Title:
From its founding, Asheville was a resort. The first tourists were farmers driving their livestock to market from Greenville, South Carolina to Greeneville, Tennessee. By the 1880's, thanks to its clean mountain air, Asheville had gained a reputation as a health resort, which attracted such luminaries as George Vanderbilt. His presence began to attract the rich and famous from around the world, and by the 1920's, the city was one of the nation's foremost locations for rest, relaxation, and recuperation. One by one, the grand hotels went up -- the Grove Park Inn, the Kenilworth Inn, the Hotel George Vanderbilt, the Battery Park Hotel, the Hotel Asheville-Biltmore... And there were dozens of rooming houses, boarding houses, and inns.
In amidst the hotels were hospitals. Our specialties? Tuberculosis sanitariums and insane asylums. The rich and famous incarcerated the relatives they wanted to forget about here. Those suffering from tuberculosis came to rest and heal in the bracing, healthful Asheville air.
The problem was that good air won't kill the infection. You're still dying. Everyone was dying. The city was filled with the sick. It was how we made our money.
Fortunes rise and fall everywhere though, and so ours did. During World War II, the federal government confiscated the resort hotels and used them as prisons. Italian POW's were housed at the Grove Park Inn. The Kenilworth Inn was turned into a hospital for wounded soldiers, and later still it became a mental hospital. The tourism industry, and the city, fell into a torpor for the next forty-odd years. It wasn't until the late 1980's and mid-1990's that we began to rebuild.
But guess what? The hotels and tuberculosis hospitals and insane asylums were still there. All that time, from the Great Depression and onward, the city had been too poor to tear them down.
And they're still standing. Most have been turned into apartment buildings. The Battery Park Hotel and the Hotel George Vanderbilt are now apartment buildings for the destitute elderly and the disabled. The Hotel Asheville-Biltmore is an apartment building for the mentally ill. Some of the old hospitals are still being used as such -- one of the tuberculosis sanitariums is an administration building for the Charles George Veterans Administration Hospital, where my father had both of his legs cut off.
Some of the hotels are back in business, such as the majestic Grove Park Inn.
Come stay a while, won't you?
Last edited by hauntedheadnc : 10-11-2008 at 05:13 AM.
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