Archaic Medical Terms

[joette]

It can depend which Borough/Health Board you live in!
Both boys born in Brent & given the inoculation shortly after birth.This is a Borough with a high immigrant population from the Indian subContinent & therefore a high risk group for TB.
They then moved to Harrow but go to school in Hertfordshire & guess what they don't do the good ole BCG at 12/13."Not a real health risk" etc.
Well I read the bumpff did my research & advised the parents to have both boys tested.Sorry but a bus ride away where they still consider it a real health threat & with the reemergence of TB in the Greater London area is a threat too far.
I still have occasional chest-x-ray as I used to work in TB unit.Call me paranoid but this is a nasty disease even with modern day treatment.

[Cathy]

My daughter had her BCG about six years ago at school, which would come under the borough of Sutton, Surrey.

[StewL]

Up until recently you had to have a clean chest x-ray to work in childcare, but now that is no longer a necessity. I got my first mantoux test done when I became a student nurse and got the necessary reaction I believe I also may have been innoculated as a matter of course too, but cant recall. I know I had all the required needles as a child in Scotland, including the horror of waiting in line in the school gym/dining hall while all the other wains were greetin and fainting. (Our whole class ended up with hysterical fainting after one lot of jabs, just took one wain to pass out and we all went over like nine pins )
As for my navy days, well! what we werent innoculated against hadnt been discovered yet

Yet with our fast international travel, and the acceptance of people from areas still very prone to those diseases which the powers that be tell us are no longer a problem. It is a distinct worry that we will return to the bad old days of people dropping of the perch from diseases that can easily be prevented. Call me cynical, but I sense more of a money saving exercise than one that the disease is no longer a problem.

[Russell]

Hi Stew
I agree with you in part that finance must be a major consideration but there are a few things have been put in place which premanently reduce the risks.
Milk is thoroughly tested at all stages and the cows get their annual medicals so Bovine TB has been effectively eradicated unless you go all organic and have access to raw milk supplies from a one cow operation who do not have their animal seen to regularly.

Respiratory forms of the disease are airborne and transmission risk is minimised by the Health & Safety regulations insisting on proper spacing of desks and workstations. Firms might not like it but it does cut down on transmissible diseases. Its a cheap preventative measure the government don't have to pay for either.

Higher standards in housing should make a difference too but there is less interference here by government in terms of numbers occupying a house or flat.
Migrants, immigrants and students are probably the major reservoir of TB in our society at present because of overcrowded accommodation. Schools/universities where there are large numbers of any of these population groups are still the commonest opportunities for onward transmission.
The other major problem is failure to complete prescribed courses of medication. It used to be a full year of Streptomycin, PAS and INAH before an all clear could be given. Newer drugs have shortened the time period and victims no longer spend half the year in hospital but many, once they are feeling better, simply stop taking the medication which allows bacterial resistance to develop. This is much the same as has happened with antibiotics.
Eventually we will have no effective drugs regimes against TB.

As Joette suggested it is better to be safe than sorry.

I still remember patients sleeping on open verandahs all year round as part of their treatment. I would hate to have to go back to that.

Russell

[HeatherH]

Hi there,
Immunization for TB was discontinued anywhere from mid 1960s to mid 1980s in Canada except for the Inuit which are at a higher risk.I had my innoculation in Newfoundland before the cutoff date in 1975 but will always test a false positive as they used a live form of the vaccine.
There has been much talk in recent years of adding the TB shot to the innoculations the children receive at school due to the increasing number of new cases popping up in recent years.
HeatherH

[StewL]

Russell

As always a very well moderated response, I again bow to your greater knowledge in these issues. I was probably having a moment in saying that it was a financial issue, although I still feel it had a hand in it.

I also should point out that I am in no way casting any dispertions on humanitarian refugees. I have worked with them and there life stories would make you shudder.

I have also undertaken studies which gives me an insight into the past causes of diseases which took a toll on our ancestors. And I agree that we are a generation which may see the results of the beneficial effects of antibiotics being reduced by the immuninity which has resulted in the over use of those very same products, resulting in the use of much more potent "antibiotics" resulting in the same immunity/tolerance of those drugs.

Even in the most recent past, ie early 1930's pre penicillin use, I believe that an aunt died of TB at the age of 13, although the official cause of death was Bronchitis/Pneumonia?, and there is suspicion? that my father had been exposed to the same disease and subsequently had a "patch" on his lungs.
Although, apart from his story, I have no direct evidence to substantiate this assumption or belief.

[DavidWW]

There's a subtle but important point here...........

It's not so much the overuse of antibiotics in itself which has led to antibiotic resistant bacteria, but the fact that many people don't complete the required course.

Any group of bacteria which are causing a problem contain bacteria with different levels of resistance to the prescribed antibiotic. (Think back to distribution curves ......)

So, in a 10 day course of a standard semi-synthetic penicillin, the drug will knock out, say, 80% of the bacteria on Day 1, 80% of the remainder on Day 2, and so on; but the problem is that people start to feel weel around Day 3 or Day 4, so don't complete the course.

That's fine except that, using the figures in the example, after Day #4 there's still 0.16% of the original bacteria population left which are obviously by this time highly resistant to penicillin, breeding healthily, and which now get spread via coughs and sneezes, and door handle contact etc. (never mind sometimes reinfecting the person involved in the first place, - Ah-hah, you've always wondered just how that happened )

Only folk who complete the 10 day course are likely to have zapped every last little coccus or bacterium .................

So next time you ask your doctor for an antibiotic when you have a cold or flu (never mind the fact these are caused by viruses which antibiotics won't affect) complete the course however good you feel after a few days, - you'll have some Staphylococcus aureus anyway quite naturally, in your nose, and under your fingernails, so why force them to evolve resistance to antibiotics ?


Repeat the process among all the various different types of penicillin, including, latterly, the highly successful combination of penicillin and clavulanic acid - "Augmentin" and various similar combinations, - the clavulanic acid knocks out an enzyme produced by the bugs which attacks the penicillin, leaving the penicillin to zap the bugs; cephalosporins; and all the rest ................

In other words, while overuse is indeed a major problem, so is misuse


And you wonder how we've ended up with major problems from MRSA ?!, - methicillin resistant Staphylococcus aureus, - until recently susceptible to vancomycin, but now, guess what?, VRSA, - vancomycin-resistant Staphylococcus aureus, - is on the increase...............

A quick google produces, -

http://www.nuflor.com/_images/new/Antib ... lasses.pdf - a reasonable summary of the classes of antibiotics.

http://www.lumen.luc.edu/Lumen/MedEd/US ... clases.ppt - but only for anyone with some chemistry, preferably biochemistry and/or pharmacology background.

And just to end up with a richt cheerful wee read, try a look at http://www.niaid.nih.gov/factsheets/antimicro.htm .............

David

PS Getting back to TB , as I understand it, the problem with the drug resistant forms that have developed in the last few years is that they are curable, but only via a course of treatment involving a complex mixture of drugs that has to be taken over a period of many months. Stop after 3 months, say, and the TB bacterium just ain't zapped.
dww