Need Lungs To Choke TB

The 바카라�little flu바카라� took the spotlight with a Usain-like bolt and conquered the planet in one (un)forgettable year. Signs are ominous it will keep its podium and headline spots through several seasons to come. Covid is the Sergei Bubka of the microbial Olympics바카라�upping its record a notch at a time. On a parallel track and away from the fuss, an ancient shadowy marathoner is continuing to amass its morbid medallions바카라�if death can be called medals, a macabre metaphor. Tuberculosis, aka TB, is a formidable ace of the long distance; a disease that has plagued humans for more than a millennium. Mycobacterium tuberculosis바카라�the bacterium that causes TB바카라�kills 1,200 people daily in India, says the World Health Organization.

The nation leads the global caseload of TB. Yet, it is something people try to avoid talking about. Why? Why is it not the fearsome disease that people dreaded three decades ago? Where has that wracking, back-bending, blood-spitting TB cough gone from our collective consciousness, from our films, from our pulp fiction? Why it바카라�s not a trending topic on our Twitters and Facebooks? Wasn바카라�t TB the chronic villain of our films of a certain vintage? Did you notice Devdas of Devdas didn바카라�t drink himself to death? TB killed him. Poverty and TB were the incurable shadows that stalked Sanjeev Kumar in Parichay (1972)바카라�a prophetic image symbolic of what this killer bacterium would become this century, 바카라�a poor man바카라�s disease of the third world바카라�. That answers why TB has gone under the radar, and not in a good way.

Tuberculosis has gone down in history as one of the oldest diseases afflicting mankind바카라�an ancestor of the Mycobacterium tuberculosis arrived on the scene more than 150 million years ago. TB killed one of seven people in the US during the 18th century, but the disease was eradicated in the developed West through elimination of poverty, improvement of nutrition and living conditions, and by isolating patients in sanitariums built off the concept of quarantine. Fresh air, a dry climate, outdoor exercises helped accelerate the healing process. For the context, this is why Dewas in Madhya Pradesh and Kumar Gandharva are linked. The classical vocalist made Dewas his home and its dry air healed him back to singing fit, despite losing a lung to TB. The arrival of the antibiotic streptomycin, the Bacille Calmette-Guérin (BCG) vaccine and new, effective drugs made the disease treatable, curable, and preventable. But TB continued to thrive in the 바카라�underdeveloped바카라� world. Like those twilight-year European league footballers playing in the Indian derby바카라�and with deadly efficiency.

The WHO estimated 10 million new global TB cases in 2017, along with 1.6 million deaths, mostly in developing countries with poor health and socioeconomic infrastructures. The bulk of the burden falls on India, where factors such as poverty, poor diet, overcrowding and pollution kept TB ticking바카라�hiding and resurfacing at ease. In fact, it has become more complex, more resistant to drugs. It has been a recurring allegation that the West has turned its back on the poorer nations in their fight against TB. 바카라�Tuberculosis doesn바카라�t bother the US and West European countries because it is a disease prevalent in poor and developing nations like India,바카라� says Dr Ishwar Gilada, president, AIDS Society of India.

Health experts say TB needs as much attention and surveillance as COVID-19 and they fear that the single-point focus on the virus could give the bacteria a free run in India, which will have deadly consequences on the population. 바카라�Since Covid has badly affected the Western countries, the media there reported the disease extensively, which is why awareness around it is a lot more. Another reason is that Covid has affected a lot of people in a very short span of time. Therefore, it is has gained more prominence than TB.바카라� The coronavirus has killed more than 3 million people worldwide since it was first detected in China in late 2019. The number of lives lost is about equal to the population of Kanpur, Lucknow, Jaipur, Pune, and Nagpur.

The total number of TB infections and deaths could be much higher in India than what data suggests because the Union health ministry바카라�s National Tuberculosis Elimination Programme (NTEP) doesn바카라�t track and trace new occurrences as actively as it does for Covid. 바카라�The online tracking mechanism in TB registers only those patients who come to hospitals on their own and are diagnosed with the disease. There is a system of contact tracing in TB, but it has to be more strengthened and stringent바카라�like they do for Covid,바카라� says Dr Neha Rastogi Panda, infectious disease expert at Fortis Hospital, Gurgaon. There are red flags everywhere. India바카라�s TB report for 2020 says 2.4 million patients were detected in 2019, but only 80 per cent received successful treatment.

Tuberculosis is far more contagious than SARS-Cov-2, the virus that causes Covid. A Covid-infected person can transmit the virus to less than two persons, according to latest research. TB can infect more than four, says Dr Sonam Solanki, a pulmonologist. But TB has existed for far longer than Covid, and making comparisons in terms of cases and mortality is not equivalent.

A bacterium causes tuberculosis, while a virus genetically related to the severe acute respiratory syndrome coronavirus causes COVID-19. Both are spread through close physical contact. When a tuberculosis-infected individual coughs, Mycobacterium tuberculosis can remain suspended in the air longer, until it바카라�s inh­aled by someone else, usually in a confined space.

The body바카라�s immune reaction to the pathogens also differs. Tuberculosis bas­ically puts a little 바카라�bunker바카라� inside your lung and hangs out there until you have a weakness in the immune system. Say you get HIV, start steroids or cancer therapy. In those weak moments, the bacteria emerge from the bunker and inf­ect the rest of your lungs.  Once activated, tuberculosis does not stay in the lungs바카라�it can infect the central nervous system, which includes the brain, muscles, skin, liver, lymph nodes and reproductive organs. Tuberculosis can persist in the body for up to 30 years.

Unlike Covid, treatment in TB prolongs for months and years and there have been umpteen latent cases, where bacterium goes into hiding after treatment and resurfaces when the person바카라�s immunity level falls. This happens bec­ause the pathogen becomes drug-res­istant following repeated use of the same medicines. Big pharma business interests and their attack-dog policies are blamed for resisting research and development of new drugs. TB aff­ects poor people and they cannot afford expensive medicines. Besides, TB medicine prices are hugely regulated in India. 바카라�Only two new drugs were developed over the past two decades. Bedaquiline and Delamanid,바카라� says Dr Gilada. The BCG vaccine, developed 80 years ago, has an efficacy rate of less than 40 per cent. For a new shot for TB, Gilada wonders if the world would ever show the urg­ency it showed for the Covid vaccines.

The reasons why tuberculosis flourishes in India are many, but the one that stands out is poverty바카라�the primal source of diseases. Give this predator a chink, it will jump the picket, invade the shielded other side. No one바카라�s safe; not even celluloid stars. It caught up with Amitabh Bachchan too, and he said in 2014 that he fought a painful bout of TB.

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Mohammad Janipasha
49, Telangana

His TB returned after 32 years, dug a big hole in his lung

Mohammad Janipasha was diagnosed with pulmonary tuberculosis when he was 17. No one in the family had the disease and it was difficult for to figure out how he got it. 바카라�I was treated and rec­overed fully,바카라� says Janipasha, a farmer in Bhadradri Kothagudem district of Telangana. As it happens with tuberculosis, the sneaky bacterium was hiding ins­ide him, waiting to strike again 32 years later. The symptoms were tell-tale바카라�Janipasha had mild fever, lost his appetite and started shedding weight. His condition deteriorated; the teetotaler coughed blood.

His doctor says he has a 바카라�big cavity바카라� in his lung. 바카라�Investigation showed his TB has resurfaced. He is getting treatment,바카라� says Dr Viswesvaran Balasubramaniam, consultant, interventional pulmonology and sleep medicine, Yashoda Hospital. He explains that TB can be broadly classified as pulmonary and extrapulmonary. 바카라�While the first one affects only the lungs, the latter can infect all organs. Janipasha was lucky that he was admitted on time and his disease was diagnosed early. Many patients lose the battle because of lack of early treatment and awareness.바카라�

Suman Sharma
45, Jharkhand

Her brain TB was a 바카라�veggie worm in the head바카라� for some doctors

A nagging, throbbing migraine-like headache came to haunt homemaker Suman Sharma when she was 30. The headache became frequent and she couldn바카라�t cope anymore. Physicians near home at Deoghar district in Jharkhand couldn바카라�t help either. She went to Patna, consulted a couple of senior doctors and an MRI test was done. 바카라�The neurologists in Patna looked at my report and said I have worms in my brain,바카라� Sharma recalls. 바카라�They said raw vegetables contain bugs and these enter the body when we eat infested veggies. The insects travel to the brain and cause problems.바카라�

Doctors put her on strong antibiotics for several months. Her headache didn바카라�t go away. Instead, the pain got more intense. She would lose consciousness. Her vision dipped too. 바카라�I went to Delhi and got admitted to AIIMS. They found brain TB,바카라� she says. Medication showed favourable signs as the first few doses started giving her relief. 바카라�I was discharged after a few days, but I remained on medication for several months. I am fully recovered now,바카라� she says.